Department of Psychological and Brain Sciences, School of Public Health, Indiana University, Bloomington, Indiana.
Program in Neuroscience, College of Arts and Sciences, School of Public Health, Indiana University, Bloomington, Indiana.
J Neurotrauma. 2020 Jan 1;37(1):146-151. doi: 10.1089/neu.2019.6550. Epub 2019 Sep 18.
Understanding the impact of concussion history on mental health-mood disorders and substance use-is an essential step in characterizing the psychological and behavioral consequences of concussion and in developing effective treatments. The objective of this study was to examine the association between the history of concussion and substance abuse by investigating both its direct and indirect association via mood disorder. A secondary objective was to determine whether gender moderates the association. A comprehensive survey was administered to 4849 college-age adults that assessed history of concussion; depression, anxiety, and panic disorders using the Patient Health Questionnaire (PHQ); and substance use using the Alcohol Use Disorders Identification Test AUDIT) (alcohol) and Cannabis Use Disorders Identification Test-Revised CUDIT) (cannabis). Regression models were used to examine the association between concussion history and substance use. Mood disorders were entered into the model as mediators and gender as a moderator variable. Those with a history of concussion had higher panic, AUDIT, and CUDIT scores than those with no history of concussion, and AUDIT and CUDIT scores showed an interaction between concussion history and gender. The regression models revealed significant direct and indirect (via depression and panic disorder) effects of concussion history on alcohol and cannabis use, which was moderated by gender. Concussion can have long-term psychological consequences and appears to affect both mood and substance use. The results presented demonstrate that the relationship between concussion and substance use is complex with mood disorder mediating the effect.
了解脑震荡史对心理健康的影响——情绪障碍和物质使用——是描述脑震荡的心理和行为后果以及开发有效治疗方法的重要步骤。本研究的目的是通过调查情绪障碍来研究脑震荡史与物质滥用之间的直接和间接关联，以研究脑震荡史与物质滥用之间的关系。次要目的是确定性别是否调节这种关联。对 4849 名成年大学生进行了一项综合调查，评估了脑震荡史；使用患者健康问卷 (PHQ) 评估抑郁、焦虑和惊恐障碍；使用酒精使用障碍识别测试 (AUDIT) (酒精) 和大麻使用障碍识别测试修订版 (CUDIT) (大麻) 评估物质使用情况。回归模型用于研究脑震荡史与物质使用之间的关联。情绪障碍作为中介，性别作为调节变量纳入模型。有脑震荡史的人比没有脑震荡史的人更容易出现惊恐、AUDIT 和 CUDIT 评分，并且 AUDIT 和 CUDIT 评分在脑震荡史和性别之间存在交互作用。回归模型显示，脑震荡史对酒精和大麻使用具有显著的直接和间接（通过抑郁和惊恐障碍）影响，而性别对其有调节作用。脑震荡可能会产生长期的心理后果，似乎会影响情绪和物质使用。所呈现的结果表明，脑震荡与物质使用之间的关系是复杂的，情绪障碍是其影响的中介。
