Durham VA Health Care System, Durham, NC, USA; Duke University Medical Center, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA.
Durham VA Health Care System, Durham, NC, USA; Duke University Medical Center, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA.
J Psychiatr Res. 2021 Jun;138:375-379. doi: 10.1016/j.jpsychires.2021.04.018. Epub 2021 Apr 22.
An association has been found between cannabis use disorder (CUD) and violence in several clinical populations, including veterans with posttraumatic stress disorder (PTSD), and there is evidence that CUD has been increasing among veterans since September 11, 2001. There is also evidence that some veterans may be attempting to self-medicate psychological problems including PTSD and aggression with cannabis, despite the lack of safety and efficacy data supporting this use. To date, however, the association between CUD and aggression has yet to be examined in a large, non-clinic sample of veterans. The present study examined the association between cannabis use disorder, anger, aggressive urges, and difficulty controlling violence in a large sample of Iraq/Afghanistan-era veterans (N = 3028). Results of multivariate logistic regressions indicated that current CUD was significantly positively associated with difficulty managing anger (OR = 2.93, p < .05), aggressive impulses/urges (OR = 2.74, p < .05), and problems controlling violence in past 30 days (OR = 2.71, p < .05) even accounting for demographic variables, comorbid symptoms of depression and PTSD, and co-morbid alcohol and substance use disorders. Lifetime CUD was also uniquely associated with problems controlling violence in the past 30 days (OR = 1.64, p < .05), but was not significantly associated with difficulty managing anger or aggressive impulses/urges. Findings indicated that the association between CUD and aggression needs to be considered in treatment planning for both CUD and problems managing anger and aggressive urges, and point to a critical need to disentangle the mechanism of the association between CUD and violence in veterans.
已经发现大麻使用障碍(CUD)与几种临床人群中的暴力行为之间存在关联,包括患有创伤后应激障碍(PTSD)的退伍军人,并且有证据表明,自 2001 年 9 月 11 日以来,退伍军人中的 CUD 一直在增加。还有证据表明,一些退伍军人可能试图用大麻来自我治疗包括 PTSD 和攻击性在内的心理问题,尽管缺乏支持这种用途的安全性和疗效数据。然而,迄今为止,CUD 与攻击性之间的关联尚未在大量非临床退伍军人样本中进行检查。本研究在大量伊拉克/阿富汗时代退伍军人样本(N=3028)中检查了大麻使用障碍、愤怒、攻击性冲动和难以控制暴力之间的关联。多元逻辑回归的结果表明,当前的 CUD 与难以控制愤怒(OR=2.93,p<.05)、攻击性冲动/冲动(OR=2.74,p<.05)和过去 30 天内控制暴力的问题(OR=2.71,p<.05)显著正相关,即使考虑到人口统计学变量、共病抑郁和 PTSD 症状以及共病酒精和物质使用障碍。终身 CUD 也与过去 30 天内控制暴力的问题(OR=1.64,p<.05)有独特的关联,但与控制愤怒或攻击性冲动/冲动的能力没有显著关联。研究结果表明,在治疗 CUD 和控制愤怒和攻击性冲动方面,需要考虑 CUD 与攻击性之间的关联,并指出迫切需要理清退伍军人中 CUD 与暴力之间关联的机制。