Kearns Nathan T, Cloutier Renee M, Carey Caitlyn, Contractor Ateka A, Blumenthal Heidemarie
Department of Psychology, University of North Texas, Denton, TX, USA.
Cannabis. 2019;2(1):39-52. doi: 10.26828/cannabis.2019.01.004. Epub 2019 Feb 9.
A growing body of work links posttraumatic stress disorder (PTSD) symptoms and substance use. Unfortunately, much of the literature has examined associations in isolation (e.g., alcohol only). Failure to account for simultaneous or concurrent substance use may limit conclusions that can be drawn from existing research, including the extent to which specific substances contribute differentially to PTSD symptom patterns. The current study examined differences in PTSD symptom profiles between individuals using one or both of the most commonly co-administered psychoactive substances - alcohol and marijuana. Trauma-exposed participants (N = 533; M = 21.15) comprised two mutually-exclusive groups: past-month alcohol-only use (n = 334) or past-month alcohol and marijuana use (n = 199). Cluster-level and symptom-level profile analyses evaluated mean differences and shape (parallelism) of PTSD symptom severity profiles between the groups. Follow-up analyses examined symptom-specific difference in PTSD symptom endorsement and severity. Overall, individuals using marijuana and alcohol evidenced greater PTSD negative cognition (30.8% greater) and hyperarousal (26.4% greater) symptom severity. Alcohol and marijuana users were more likely to endorse, and report greater severity of, mood-related PTSD negative cognition symptoms (e.g., anhedonia, negative affect) and externalizing hyperarousal symptom (e.g., irritability/aggression, risky behaviors) than alcohol-only users. Findings highlight important PTSD differences between individuals that are often lumped into homogenous categories of isolated substance users. Findings provide preliminary support for an 'additive' self-medication model between PTSD and polysubstance use. Lastly, findings indicate that mood-related negative cognition symptoms and externalizing hyperarousal symptoms may be important targets for PTSD-polysubstance use intervention.
越来越多的研究将创伤后应激障碍（PTSD）症状与物质使用联系起来。不幸的是，许多文献都孤立地研究了两者之间的关联（例如，仅研究酒精）。未能考虑同时或并发的物质使用情况可能会限制从现有研究中得出的结论，包括特定物质对PTSD症状模式的不同影响程度。本研究调查了使用两种最常共同使用的精神活性物质——酒精和大麻中的一种或两种的个体之间PTSD症状特征的差异。经历过创伤的参与者（N = 533；M = 21.15）分为两个相互排斥的组：过去一个月仅使用酒精的组（n = 334）或过去一个月同时使用酒精和大麻的组（n = 199）。聚类水平和症状水平的特征分析评估了两组之间PTSD症状严重程度特征的平均差异和形状（平行性）。后续分析检查了PTSD症状认可和严重程度方面的症状特异性差异。总体而言，同时使用大麻和酒精的个体表现出更严重的PTSD负面认知（高出30.8%）和过度警觉（高出26.4%）症状。与仅使用酒精的使用者相比，同时使用酒精和大麻的使用者更有可能认可并报告与情绪相关的PTSD负面认知症状（例如，快感缺失、消极情绪）和外化性过度警觉症状（例如，易怒/攻击性、危险行为）的严重程度更高。研究结果突出了那些常常被归为单一物质使用者同类别的个体之间PTSD的重要差异。研究结果为PTSD与多种物质使用之间的“相加性”自我药物治疗模型提供了初步支持。最后，研究结果表明，与情绪相关的负面认知症状和外化性过度警觉症状可能是PTSD - 多种物质使用干预的重要目标。
