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创伤暴露学生中 PTSD 症状与 binge drinking 之间的个体内关联。

Intraindividual association of PTSD symptoms with binge drinking among trauma-exposed students.

机构信息

Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University.

出版信息

J Couns Psychol. 2021 Oct;68(5):571-581. doi: 10.1037/cou0000543. Epub 2021 Mar 25.

Abstract

People, particularly undergraduate students, who report elevated symptoms of posttraumatic stress disorder (PTSD) are at elevated risk of binge drinking. The present study used ecological momentary assessment to (a) evaluate whether PTSD severity, specifically, or psychological distress, generally, are associated with binge drinking and (b) examine the self-medication and susceptibility models of the comorbidity of PTSD with binge drinking while accounting for shared liability (i.e., the between-person association of PTSD symptom severity with binge drinking). Within a larger study of undergraduate student mental health, for 14 days, students who reported a potentially traumatic experience (N = 276) reported nightly on use of alcohol and psychoactive substances and thrice daily on current affect, internalizing symptoms, and PTSD symptoms. Daily binge drinking, per the NIAAA definition, was analyzed using multivariate mixed effects, multilevel logistic regression. Results support the self-medication model; participants were more likely to binge drink on days marked by elevated PTSD symptoms, OR = 2.82, p < .01. Binge drinking was also more likely on weekends, OR = 4.21, p < .0001, and days marked by elevated daily positive affect, OR = 1.60, p < .001. Binge drinking was not associated with concurrent depressive or general anxiety symptoms (p > .30). PTSD symptoms were not associated with use of cannabis or other substances (p > .06). Regarding the susceptibility model, following a binge drinking episode, participants reported elevated depressive symptoms, B = 0.34, p = .04, but no change in affect, PTSD symptoms, or general anxiety symptoms (p > .16). Results suggest that, beyond understanding who is at risk for binge drinking, fluctuations in PTSD severity clarify when students engage in binge drinking. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

摘要

报告创伤后应激障碍(PTSD)症状升高的人,如大学生,酗酒的风险更高。本研究使用生态瞬时评估来(a)评估 PTSD 严重程度,特别是心理困扰,是否与酗酒有关,以及(b)在考虑共同发病机制(即 PTSD 症状严重程度与酗酒之间的个体间关联)的情况下,检验 PTSD 与酗酒共病的自我用药和易感性模型。在一项关于大学生心理健康的更大研究中,对于报告过潜在创伤经历的学生(N=276),在 14 天内,他们每晚报告一次饮酒和精神活性物质的使用情况,每日三次报告当前情绪、内化症状和 PTSD 症状。根据 NIAAA 的定义,使用多元混合效应、多层逻辑回归分析每日 binge 饮酒情况。结果支持自我用药模型;参与者在 PTSD 症状升高的日子里更有可能 binge 饮酒,OR=2.82,p<.01。Binge 饮酒也更可能发生在周末,OR=4.21,p<.0001,以及在每日正性情绪升高的日子里,OR=1.60,p<.001。同时存在的抑郁或一般焦虑症状与 binge 饮酒无关(p>.30)。PTSD 症状与大麻或其他物质的使用无关(p>.06)。关于易感性模型,在 binge 饮酒事件后,参与者报告抑郁症状加重,B=0.34,p=0.04,但情绪、PTSD 症状或一般焦虑症状没有变化(p>.16)。结果表明,除了了解谁有酗酒风险之外,PTSD 严重程度的波动可以明确学生何时会发生 binge 饮酒。

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