Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
J Subst Abuse Treat. 2021 Feb;121:108198. doi: 10.1016/j.jsat.2020.108198. Epub 2020 Nov 13.
Research has described subtypes with more internalizing and more externalizing symptoms in samples of patients with post-traumatic stress disorder (PTSD) and samples of patients with substance use disorders (SUD).
This study sought to examine the respective subtypes in female PTSD-SUD patients and potential relationships with substance use characteristics.
We performed a latent class analysis (LCA) in 343 adult female participants of a multisite therapy trial on PTSD and SUD. We derived externalizing symptoms from the Assessment of DSM-IV Personality Disorders (ADP-IV) questionnaire. We assessed internalization using the Symptom Checklist-27 (SCL-27) and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). We collected substance use-related information using the Addiction Severity Index-Lite (ASI-lite).
LCA suggested four latent classes including an externalizing (10.8%), a moderately internalizing class (31.0%), and a highly internalizing class (22.0%), as well as a class with a low severity of psychological symptoms (36.3%). Externalizing participants used more substances than any other class, while the duration of substance use did not differ between groups. Regular use started at a significantly younger age among the members of the highly internalizing subgroup compared to the moderately internalizing and low severity participants, but at an older age compared to the externalizing group members.
The finding of two internalizing subgroups along with an externalizing and a low severity class emphasizes the heterogeneity and complexity of populations with PTSD and SUD. This heterogeneity bears implications for research among this group of patients, but also for their treatment, especially considering our results on differences in substance use.
研究已经在创伤后应激障碍（PTSD）患者样本和物质使用障碍（SUD）患者样本中描述了具有更多内化和更多外化症状的亚型。
本研究旨在检查 PTSD-SUD 女性患者中的各自亚型，以及与物质使用特征的潜在关系。
我们对一项多地点 PTSD 和 SUD 治疗试验的 343 名成年女性参与者进行了潜在类别分析（LCA）。我们从DSM-IV 人格障碍评估问卷（ADP-IV）中得出外化症状。我们使用症状清单-27（SCL-27）和DSM-IV 轴 I 障碍结构化临床访谈（SCID-I）评估内化。我们使用成瘾严重程度指数-精简版（ASI-lite）收集与物质使用相关的信息。
LCA 表明存在四个潜在类别，包括外化（10.8%）、中度内化类（31.0%）和高度内化类（22.0%），以及心理症状严重程度低的类别（36.3%）。外化组参与者使用的物质比任何其他类别都多，而各组之间的物质使用持续时间没有差异。与中度内化和低严重度参与者相比，高度内化亚组的成员开始定期使用的年龄明显较小，但与外化组的成员相比，开始使用的年龄较大。
发现两个内化亚组以及一个外化和一个低严重度组，强调了 PTSD 和 SUD 患者群体的异质性和复杂性。这种异质性对该组患者的研究具有影响，但也对他们的治疗具有影响，尤其是考虑到我们在物质使用方面的差异结果。
