Virginia Institute for Psychiatric and Behavioral Genetics.
Department of Psychology and Department of Human and Molecular Genetics.
Psychol Addict Behav. 2020 May;34(3):465-476. doi: 10.1037/adb0000552. Epub 2020 Feb 6.
Multiple etiological models have been proposed to explain posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) comorbidity, but the predominant model to date is the "drinking to cope" self-medication model. Despite its popularity, the self-medication model lacks rigorous empirical support related to inconsistencies and methodological limitations, particularly the failure to operationalize drinking to cope with trauma symptoms specifically. The present study sought to measure trauma-related drinking to cope (TRD) in order to provide a more specific test of the self-medication model among a representative sample of 1,896 undergraduates with a history of trauma exposure and alcohol use. Using a model-building approach in M, a correlated multiple mediator model tested the association between PTSD symptoms and alcohol use problems (AUPs) through TRD and more generalized drinking to cope motives (as assessed by the coping subscale of the Drinking Motives Questionnaire; DMQ-Cope) as moderated by sex. Results indicated that, while accounting for the effects of generalized drinking to cope motives, TRD partially mediated the relation between PTSD symptoms and AUPs and that this relationship was stronger for males than for females. With the exception of moderation by sex, results were substantiated using longitudinal data. Findings were consistent with the self-medication model, suggesting that TRD motives may serve as a mechanism through which PTSD symptoms influence AUPs. TRD may serve as a more specific screening tool for AUP risk among individuals endorsing PTSD symptoms compared with the commonly used DMQ-Cope. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
已经提出了多种病因学模型来解释创伤后应激障碍（PTSD）和酒精使用障碍（AUD）共病，但迄今为止占主导地位的模型是“饮酒应对”自我药物治疗模型。尽管该模型很流行，但缺乏与不一致和方法学限制相关的严格的实证支持，特别是未能具体实施用饮酒来应对创伤症状。本研究旨在测量与创伤相关的饮酒应对（TRD），以便在一个有创伤暴露和饮酒史的 1896 名本科生的代表性样本中，更具体地检验自我药物治疗模型。在 M 中使用模型构建方法，一个相关的多重中介模型通过 TRD 和更普遍的饮酒应对动机（由饮酒动机问卷的应对子量表评估；DMQ-Cope）来检验 PTSD 症状和酒精使用问题（AUPs）之间的关联，该模型由性别调节。结果表明，在考虑到一般饮酒应对动机的影响后，TRD 部分中介了 PTSD 症状与 AUPs 之间的关系，并且这种关系在男性中比女性更强。除了性别调节之外，使用纵向数据也得到了证实。研究结果与自我药物治疗模型一致，表明 TRD 动机可能是 PTSD 症状影响 AUPs 的一种机制。与常用的 DMQ-Cope 相比，TRD 可能是一种更具体的 PTSD 症状个体 AUP 风险的筛查工具。
