Romero-Sanchiz Pablo, Mahu Ioan T, Barrett Sean P, Salmon Joshua P, Al-Hamdani Mohammed, Swansburg Jennifer E, Stewart Sherry H
University of Roehampton, School of Psychology, Whitelands College, SW15 4JD, Holybourne Ave, London, United Kingdom; Dalhousie University, Department of Psychology and Neuroscience, Life Sciences Centre, 1355 Oxford Street, PO Box 15000, B3H 4J1 Halifax, Nova Scotia, Canada.
Dalhousie University, Department of Psychology and Neuroscience, Life Sciences Centre, 1355 Oxford Street, PO Box 15000, B3H 4J1 Halifax, Nova Scotia, Canada.
Addict Behav. 2022 Feb;125:107126. doi: 10.1016/j.addbeh.2021.107126. Epub 2021 Sep 27.
Conditioned craving to trauma cues and avoidance learning have both been implicated in the high concurrence of trauma-related distress and substance misuse. Using a cue-exposure paradigm involving personalized trauma, cannabis, and neutral cues, we examined if conditioned craving and/or elevated negative affect to trauma cues are mechanisms linking PTSD and cannabis use disorder. Fifty-one trauma-exposed cannabis users were randomly presented the three cue types. Craving and emotional responses were evaluated after each cue using the Marijuana Craving Questionnaire-Short Form (Heishman et al., 2001) and the Positive and Negative Affect Schedule (Watson et al., 1988). Relief cannabis craving (compulsivity and emotionality) was significantly higher after trauma than cannabis and neutral cues (p's < 0.001) and was also higher among those with more severe PTSD symptoms (p's < 0.05). The relationship between PTSD symptom severity and cannabis craving was stronger after trauma than cannabis cues for the compulsivity component of craving (p < .05). Relief craving was also higher after the cannabis cue than after the neutral cue (expectancy and purposefulness; p < .001). Negative affect was significantly higher: after trauma than cannabis and neutral cues (p's < 0.001); and among those with more severe PTSD symptoms (p < . 005). Positive affect was significantly lower after trauma than cannabis cues (p < .05). Trauma cue exposure might promote cannabis misuse through conditioned craving as well as the desire to relieve negative affect. Conditioned cannabis craving involving an uncontrollable compulsion to use cannabis in response to trauma reminders appears particularly likely among cannabis users with more severe PTSD symptoms.
对创伤线索的条件性渴望和回避学习都与创伤相关痛苦和物质滥用的高度并发有关。我们使用了一种涉及个性化创伤、大麻和中性线索的线索暴露范式，来研究对创伤线索的条件性渴望和/或消极情绪增强是否是将创伤后应激障碍（PTSD）与大麻使用障碍联系起来的机制。51名有创伤经历的大麻使用者被随机呈现这三种线索类型。每次线索呈现后，使用大麻渴望问卷简版（Heishman等人，2001年）和正负性情绪量表（Watson等人，1988年）评估渴望和情绪反应。创伤线索呈现后缓解大麻渴望（强迫性和情绪性）显著高于大麻和中性线索（p值<0.001），在PTSD症状更严重的人群中也更高（p值<0.05）。对于渴望的强迫性成分，创伤线索呈现后PTSD症状严重程度与大麻渴望之间的关系比大麻线索呈现后更强（p<0.05）。大麻线索呈现后的缓解渴望也高于中性线索（预期性和目的性；p<0.001）。消极情绪显著更高：创伤线索呈现后高于大麻和中性线索（p值<0.001）；在PTSD症状更严重的人群中也更高（p<0.005）。创伤线索呈现后的积极情绪显著低于大麻线索（p<0.05）。创伤线索暴露可能通过条件性渴望以及缓解消极情绪的愿望来促进大麻滥用。在PTSD症状更严重的大麻使用者中，涉及对创伤提示物做出反应而不可控制地强迫使用大麻的条件性大麻渴望似乎尤其可能出现。
