Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.
Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
J Trauma Stress. 2022 Feb;35(1):178-185. doi: 10.1002/jts.22715. Epub 2021 Jul 19.
Cannabis use is common among individuals with posttraumatic stress disorder (PTSD), although its use can ultimately worsen PTSD outcomes. Cannabis-use coping motives may help explain the PTSD-cannabis relationship. Frequent pairing of trauma cues with substance use to cope with negative affect can lead to conditioned substance craving. For the present cue-reactivity study, we examined if PTSD symptoms were associated with cannabis craving elicited by a personalized trauma cue and explored whether coping motives mediated this hypothesized relationship; enhancement motives were included as a comparison mediator. Participants (N = 51) were trauma-exposed cannabis users who completed validated assessments on PTSD symptom severity and cannabis use motives. They were then exposed to a personalized audiovisual cue based on their own traumatic experience after which they responded to questions on a standardized measure regarding their cannabis craving. The results demonstrated that PTSD symptoms were associated with increased cannabis craving following trauma cue exposure, B = 0.43, p = .004, 95% CI [0.14, 0.72]. However, the results did not support our hypothesis of an indirect effect through general coping motives, indirect effect = .03, SE = .08, 95% CI [-.10, .21]. We found an independent main effect of general coping motives on trauma cue-elicited cannabis craving, B = 1.86, p = .002, 95% CI [0.72, 3.01]. These findings have important clinical implications suggesting that clinicians should target both PTSD symptoms and general coping motives to prevent the development of conditioned cannabis craving to trauma reminders in trauma-exposed cannabis users.
大麻使用在创伤后应激障碍（PTSD）患者中很常见，尽管它的使用最终可能会使 PTSD 患者的预后恶化。大麻使用应对动机可能有助于解释 PTSD 与大麻的关系。创伤线索与物质使用的频繁结合可以用来应对负面情绪，从而导致条件性物质渴求。在目前的线索反应研究中，我们研究了 PTSD 症状是否与由个性化创伤线索引起的大麻渴求有关，并探讨了应对动机是否在假设的关系中起中介作用；增强动机被纳入比较中介。参与者（N = 51）为创伤后大麻使用者，他们完成了 PTSD 症状严重程度和大麻使用动机的有效评估。然后，他们接受了基于自己创伤经历的个性化视听线索刺激，之后他们根据标准化量表回答了关于大麻渴求的问题。结果表明，PTSD 症状与创伤线索暴露后大麻渴求的增加有关，B = 0.43，p =.004，95%CI [0.14，0.72]。然而，结果并不支持我们通过一般应对动机产生间接影响的假设，间接效应 =.03，SE =.08，95%CI [-.10，.21]。我们发现一般应对动机对创伤线索诱发的大麻渴求有独立的主要影响，B = 1.86，p =.002，95%CI [0.72，3.01]。这些发现具有重要的临床意义，表明临床医生应该针对 PTSD 症状和一般应对动机，以防止创伤后大麻使用者对创伤提示产生条件性大麻渴求。
