亚裔美国人的创伤后应激症状、羞耻感和物质使用。
Posttraumatic stress symptoms, shame, and substance use among Asian Americans.
机构信息
The City College of New York, The City University of New York, 160 Convent Avenue, New York, NY 10031, USA; Derner School of Psychology, Adelphi University, 158 Cambridge Avenue, Garden City, NY 11530, USA.
Columbia University Medical Center, Department of Psychiatry and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
出版信息
J Subst Abuse Treat. 2019 Jan;96:1-11. doi: 10.1016/j.jsat.2018.10.002. Epub 2018 Oct 10.
BACKGROUND
To examine the association between posttraumatic stress symptoms (PTSS) and substance use among Asian Americans and the influence of a culturally-relevant moderator, shame.
METHODS
From 2016 to 2017, 199 participants from Amazon Mechanical Turk and a university subject pool completed an online survey. Chi-square and Kruskal-Wallis tests explored demographic and clinical differences among three Asian American ethnic subgroups (East Asians, South Asians, and Southeast Asians). Generalized linear models assessed the association between PTSS and substance use (alcohol, tobacco, and other drugs) and the moderation of this relationship by shame.
RESULTS
Ethnic subgroups significantly differed on all three substance use variables. The severity in PTSS was significantly associated with hazardous drug use (IRR = 1.03, (1.01, 1.05), p = .003). The association between PTSS and days of tobacco use and binge drinking was significantly moderated by shame. Low levels of shame increased the effect of PTSS on binge drinking (IRR = 1.05, (1.00, 1.10), p = .035) and tobacco use (IRR = 1.15, (1.11, 1.19), p < .001). High levels of shame had no effect of PTSS on binge drinking (IRR = 1.01, (0.99, 1.03), p = .54) and a reduced effect on tobacco use (IRR = 1.07, (1.05, 1.09), p < .001).
CONCLUSIONS
Among Asian Americans, the association of PTSS and substance use depends on shame. Lower levels of shame are a risk factor, increasing the effect of PTSS on substance use. Culturally-modified addiction treatments should assess for shame among Asian Americans and attend to ethnic sub-group diversity in substance use.
背景
本研究旨在考察创伤后应激症状（PTSS）与亚洲裔美国人物质使用之间的关系，以及文化相关调节因素（羞耻感）的影响。
方法
2016 年至 2017 年，来自亚马逊 Mechanical Turk 和一所大学的受试者库的 199 名参与者完成了一项在线调查。卡方检验和克鲁斯卡尔-沃利斯检验用于探讨三个亚洲裔美国人亚组（东亚人、南亚人和东南亚人）之间的人口统计学和临床差异。广义线性模型评估了 PTSS 与物质使用（酒精、烟草和其他药物）之间的关联，以及羞耻感对这种关系的调节作用。
结果
在所有三种物质使用变量上，亚组之间存在显著差异。PTSS 的严重程度与危险药物使用显著相关（IRR=1.03，（1.01，1.05），p=0.003）。PTSS 与吸烟和酗酒天数之间的关联，被羞耻感显著调节。羞耻感水平低会增加 PTSS 对酗酒（IRR=1.05，（1.00，1.10），p=0.035）和吸烟（IRR=1.15，（1.11，1.19），p<0.001）的影响。羞耻感水平高对 PTSS 与酗酒之间的关系没有影响（IRR=1.01，（0.99，1.03），p=0.54），但对吸烟的影响降低（IRR=1.07，（1.05，1.09），p<0.001）。
结论
在亚洲裔美国人中，PTSS 和物质使用之间的关联取决于羞耻感。较低水平的羞耻感是一个风险因素，会增加 PTSS 对物质使用的影响。文化修正的成瘾治疗方法应该在亚洲裔美国人中评估羞耻感，并关注物质使用的种族亚组多样性。
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