University of Missouri-St. Louis, United States.
SUNY Downstate Medical Center, United States.
Addict Behav. 2021 Jan;112:106640. doi: 10.1016/j.addbeh.2020.106640. Epub 2020 Sep 3.
The co-occurrence of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) is widely known, yet few studies have examined whether and how AUD symptoms co-occur with PTSD symptom clusters of hypervigilance, avoidance/numbing, and re-experiencing. The purpose of this study was to examine potential overlap between AUD and posttraumatic stress symptomatology, and to characterize the resultant latent classes in terms of demographics, drinking behaviors, parental AUD, and specific traumas experienced (physical violence, sexual violence, and non-assaultive trauma). We hypothesized that classes would be differentiated by type and severity of AUD and PTS symptoms. Drawing from a sample of white and Black participants from the Collaborative Study on the Genetics of Alcoholism (COGA), we examined young adults between the ages of 18-35 who had experienced trauma (N = 2478). A series of LCA models based on the type of trauma experienced, posttraumatic stress symptoms and problematic alcohol use were then fitted to the data. A four-class solution provided the best fit, consisting of a low symptom class (N = 1134), moderate alcohol/low PTS severity (N = 623), mild alcohol/high PTS severity (N = 544), and high symptom severity (N = 177). Higher prevalence of sexual assault was associated with membership in high PTS severity classes, and parent AUD was associated with membership in each class, particularly when the mother or both parents had the disorder. Using person-centered methods such as LCA is a commonsense approach to understanding the heterogeneity of symptoms, trauma types, and individual-level characteristics associated with trauma-exposed individuals and comorbid AUD-PTSD, and our study is one of relatively few to empirically ascertain the co-occurrence of alcohol and PTS symptoms in a high-risk family sample.
创伤后应激障碍(PTSD)和酒精使用障碍(AUD)同时发生是众所周知的,但很少有研究探讨 AUD 症状是否以及如何与警觉过度、回避/麻木和再体验等 PTSD 症状群同时发生。本研究的目的是检验 AUD 与 PTSD 症状之间的潜在重叠,并根据人口统计学、饮酒行为、父母 AUD 和经历的特定创伤(身体暴力、性暴力和非攻击性创伤)来描述由此产生的潜在类别。我们假设类别将根据 AUD 和 PTS 症状的类型和严重程度来区分。本研究从酒精遗传合作研究(COGA)的白人和黑人参与者中抽取了样本,研究了经历过创伤的 18-35 岁的年轻人(N=2478)。然后,根据所经历的创伤类型、创伤后应激症状和问题性饮酒,对一系列基于 LCA 的模型进行了拟合。一个包含四个类别的解决方案提供了最佳拟合,包括低症状类(N=1134)、中度酒精/低 PTS 严重程度类(N=623)、轻度酒精/高 PTS 严重程度类(N=544)和高症状严重程度类(N=177)。性侵犯的高患病率与 PTS 严重程度高的类别有关,而父母 AUD 与每个类别的成员有关,尤其是当母亲或父母双方都有这种疾病时。使用基于个体的方法(如 LCA)是一种理解与创伤暴露个体和共病 AUD-PTSD 相关的症状、创伤类型和个体特征异质性的常识方法,我们的研究是为数不多的实证确定高危家庭样本中酒精和 PTS 症状同时发生的研究之一。