Lyons Robert, Haller Moira, Curry Inga, Norman Sonya B
San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, California, USA.
Veterans Affairs San Diego Healthcare System, La Jolla, California, USA.
Subst Abus. 2020;41(1):132-138. doi: 10.1080/08897077.2019.1635957. Epub 2019 Jul 17.
The comorbidity of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) is highly prevalent and associated with especially poor psychosocial functioning. Negative trauma-related cognitions are theoretically proposed to be associated with poor psychosocial functioning in PTSD, but few studies have examined the association between negative trauma-related cognitions and psychosocial functioning in PTSD/AUD. Evaluating this association may provide evidence of a potential treatment target for improving psychosocial functioning in PTSD/AUD. We hypothesized that negative trauma-related cognitions, including cognitions about the self, world, and self-blame, would be independently associated with poor psychosocial functioning in the following domains: vitality, psychosocial well-being, role limitations due to emotional distress, and social functioning. We examined the relationship between negative trauma-related cognitions and psychosocial functioning in 145 treatment-seeking veterans with PTSD/AUD using multiple linear regression analyses while controlling for PTSD and alcohol abuse and dependence severity. Our hypotheses were partially supported. We found that negative trauma-related cognitions were uniquely associated with greater psychosocial functional impairment, independent of PTSD and alcohol abuse and dependence severity. Specifically, negative trauma-related cognitions about the self were associated with greater psychosocial functional impairment across all domains, cognitions about the world were associated with worse social functioning and psychological well-being, and self-blame was associated with impaired psychological well-being. Given that improvements in negative trauma-related cognitions are a mechanism of trauma-focused treatment, future studies should examine whether changes in negative trauma-related cognitions through trauma-focused treatment are associated with improved psychosocial functioning.
创伤后应激障碍（PTSD）与酒精使用障碍（AUD）的共病极为普遍，且与特别差的心理社会功能相关。理论上认为，与创伤相关的消极认知与PTSD中较差的心理社会功能有关，但很少有研究考察PTSD/AUD中与创伤相关的消极认知和心理社会功能之间的关联。评估这种关联可能为改善PTSD/AUD心理社会功能的潜在治疗靶点提供证据。我们假设，与创伤相关的消极认知，包括关于自我、世界和自责的认知，将在以下领域与较差的心理社会功能独立相关：活力、心理社会幸福感、因情绪困扰导致的角色受限以及社会功能。我们使用多元线性回归分析，在控制PTSD以及酒精滥用和依赖严重程度的同时，研究了145名寻求治疗的患有PTSD/AUD的退伍军人中与创伤相关的消极认知和心理社会功能之间的关系。我们的假设得到了部分支持。我们发现，与创伤相关的消极认知与更大的心理社会功能损害存在独特关联，独立于PTSD以及酒精滥用和依赖严重程度。具体而言，关于自我的与创伤相关的消极认知在所有领域都与更大的心理社会功能损害相关，关于世界的认知与更差的社会功能和心理幸福感相关，而自责与受损的心理幸福感相关。鉴于改善与创伤相关的消极认知是聚焦创伤治疗的一种机制，未来的研究应考察通过聚焦创伤治疗改变与创伤相关的消极认知是否与改善心理社会功能相关。
