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青少年早期酗酒会增加9·11事件后退伍军人出现精神病理学问题的风险,轻度创伤性脑损伤会加剧症状严重程度。

Early Adolescent Binge Drinking Increases Risk of Psychopathology in Post-9/11 Veterans and Mild Traumatic Brain Injury Exacerbates Symptom Severity.

作者信息

Fortier Catherine B, Whitworth James W, Fonda Jennifer R, Currao Alyssa, Beck Brigitta M, Levin Laura, Esterman Michael, Milberg William P, McGlinchey Regina E

机构信息

Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, 150 S. Huntington Avenue, Boston, MA 02130, USA.

Geriatric Research, Educational and Clinical Center (GRECC), VA Boston Healthcare System, 150 S. Huntington Avenue, Boston, MA 02130, USA.

出版信息

Alcohol Alcohol. 2021 Jan 4;56(1):116-124. doi: 10.1093/alcalc/agaa075.

Abstract

AIMS

To demonstrate that early adolescent binge drinking (BD) increases the risk for and/or severity of psychopathology in post-9/11 Veterans and determine if mild traumatic brain injury (mTBI) modifies risk.

METHODS

Post-9/11 Veterans (n = 375) were classified into two groups: 57 Veterans with a history of early adolescent BD (E-BD; age of onset <15) and 318 who did not BD until age 15 or older (late-BD or L-BD; age of onset ≥15). History of military mTBI and mental health disorders were also assessed following military service.

RESULTS

Logistic regression and analysis of variance (ANOVA) analyses revealed that the E-BD's had significantly higher prevalence of alcohol use disorders (AUDs) and more severe symptoms of AUD, substance use disorder (SUD), depression and stress. Two-way ANOVAs showed that history of military mTBI was differentially associated with posttraumatic stress disorder (PTSD) incidence and severity among Veterans who had engaged in early adolescent BD. Specifically, Veterans with a history of both early adolescent BD and military mTBI were at greater risk for a PTSD diagnosis and had more severe symptoms of PTSD than those with only a history of adolescent BD. The greater PTSD symptom severity in the comorbid group was driven by hyperarousal symptoms.

CONCLUSIONS

A history of BD during early adolescence is prevalent among Veterans and is related to higher risk for AUD and more severe AUD, SUD, mood and stress symptoms later in life. Veterans with early BD and military mTBI showed greater incidence and severity of PTSD, indicating that mTBI, a common comorbidity among post-9/11 Veterans, exacerbates risk.

摘要

目的

证明青少年早期酗酒(BD)会增加9·11事件后退伍军人精神病理学的风险和/或严重程度,并确定轻度创伤性脑损伤(mTBI)是否会改变风险。

方法

将9·11事件后的退伍军人(n = 375)分为两组:57名有青少年早期酗酒史(E-BD;发病年龄<15岁)的退伍军人和318名直到15岁或更晚才开始酗酒的退伍军人(晚期酗酒或L-BD;发病年龄≥15岁)。还在退伍军人服役后评估了军事性mTBI和心理健康障碍的病史。

结果

逻辑回归和方差分析(ANOVA)分析显示,E-BD组酒精使用障碍(AUDs)的患病率显著更高,且AUD、物质使用障碍(SUD)、抑郁症和压力的症状更严重。双向方差分析表明军事性mTBI病史与青少年早期酗酒的退伍军人创伤后应激障碍(PTSD)的发病率和严重程度存在差异关联。具体而言,有青少年早期酗酒和军事性mTBI病史的退伍军人比只有青少年酗酒史的退伍军人患PTSD的风险更高,且PTSD症状更严重。共病组中PTSD症状更严重是由过度觉醒症状导致的。

结论

青少年早期酗酒史在退伍军人中很普遍,并且与晚年患AUD的更高风险以及更严重的AUD、SUD、情绪和压力症状有关。有早期酗酒和军事性mTBI的退伍军人PTSD的发病率和严重程度更高,这表明mTBI作为9·11事件后退伍军人中常见的共病,会加剧风险。

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