创伤后应激障碍症状的异质性与美国退伍军人的酒精相关结局：与应对策略的间接关联。
PTSD symptom heterogeneity and alcohol-related outcomes in U.S. military veterans: Indirect associations with coping strategies.
机构信息
Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; US Department of Veteran Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA.
Department of Psychiatry, University of California, San Diego, CA, USA; VA Center of Excellence for Stress and Mental Health, San Diego, CA, USA; US Department of Veteran Affairs National Center for Posttraumatic Stress Disorder, White River Junction, VT, USA; VA San Diego Healthcare System, San Diego, CA.
出版信息
J Anxiety Disord. 2022 Jan;85:102496. doi: 10.1016/j.janxdis.2021.102496. Epub 2021 Nov 6.
INTRODUCTION
This study investigated the role of coping strategies in mediating the relationship between the 7-factor model of posttraumatic stress disorder (PTSD) symptoms and alcohol misuse in veterans.
METHODS
Data were analyzed from 615 veterans from a nationally representative study of U.S. veterans who met criteria for probable full or subthreshold PTSD. Path analyses examined the role of self-sufficient, socially-supported, and avoidant coping strategies in mediating associations between PTSD symptom clusters and alcohol use disorder (AUD), alcohol consumption, and alcohol-related consequences.
RESULTS
Negative affect PTSD symptoms were associated with AUD through increased use of avoidant coping. Additionally, dysphoric arousal PTSD symptoms were associated with AUD; avoidant coping was associated with AUD and increased alcohol consumption; self-sufficient coping was associated with reduced AUD likelihood anhedonia symptoms with decreased use of self-sufficient coping; and negative affect with decreased use of socially-supported coping and increased use of avoidant coping.
CONCLUSIONS
Results underscore the importance of avoidant coping strategies as potential mediators of the relation between PTSD symptoms and AUD. Interventions designed to mitigate engagement in avoidant coping strategies, and to bolster engagement in self-sufficient and socially-supported strategies may help reduce alcohol misuse in veterans with full or subthreshold PTSD.
引言
本研究调查了应对策略在调解创伤后应激障碍（PTSD）症状的 7 因素模型与退伍军人酗酒之间关系中的作用。
方法
对来自美国退伍军人全国代表性研究的 615 名符合完全或阈下 PTSD 标准的退伍军人的数据进行了分析。路径分析检验了自足、社会支持和回避应对策略在调解 PTSD 症状群与酒精使用障碍（AUD）、饮酒量和酒精相关后果之间关联中的作用。
结果
负性情绪 PTSD 症状通过增加回避应对与 AUD 相关。此外，烦躁觉醒 PTSD 症状与 AUD 相关；回避应对与 AUD 和饮酒量增加相关；自足应对与 AUD 可能性降低相关，与自足应对减少相关；负性情绪与社会支持应对减少和回避应对增加相关。
结论
结果强调了回避应对策略作为 PTSD 症状与 AUD 之间关系的潜在中介的重要性。旨在减轻回避应对策略的参与度，并加强自足和社会支持策略的参与度的干预措施，可能有助于减少有完全或阈下 PTSD 的退伍军人的酒精滥用。
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