Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Florida, Miami, US.
Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Florida, Miami, US.
BMC Psychiatry. 2022 Apr 22;22(1):287. doi: 10.1186/s12888-022-03931-1.
History of exposure to traumatic events (ETE) is common among women in substance use disorder (SUD) treatment and is related to craving. We examined whether ETE (i.e., emotional, physical, sexual abuse) in childhood, adulthood, or both is related to craving via trauma symptoms and how trait mindfulness might attenuate this association.
Baseline data from a larger randomized clinical trial of a mindfulness-based intervention for women (N = 245) in SUD treatment were used. Inclusion criteria were: 18-65 years of age, SUD diagnosis, English fluency, no cognitive impairment, and willingness to be audio recorded and provide consent. Demographics and validated measures of ETE, posttraumatic stress symptoms, trait mindfulness, and substance use craving were collected via in-person interviews. Descriptive statistics, correlational analysis, and relative direct, indirect, and conditional indirect effects models were run.
Most participants identified as Hispanic (58.5%), had at least a high school education (52.2%), with a mean age of 32.2. Women reported ETE in childhood only (20.4%), adulthood only (17.5%), both childhood and adulthood (50.0%), and never (11.4%). Compared to women with ETE in both childhood and adulthood, those with exposure in adulthood only (β = -.10, 95% CI = -.20, -.02) or no exposure (β = -.11, 95% CI = -.23, -.03; [∆R .347, F(8, 245) = 15.7, p < .001) had lower craving via lower trauma symptomatology but no difference when compared to those with ETE only in childhood. Acting with awareness moderated this indirect effect (∆R = .04, F(3, 245) = 4.66, p = .004. At low levels of awareness, women with ETE during both childhood and adulthood reported higher craving via trauma symptomatology than women with no exposure or only adulthood exposure.
Low levels of acting with awareness may worsen trauma symptoms after ETE, which in turn may lead to more craving for women in substance use treatment. Despite a small moderating effect size, acting with awareness may have clinical significance due to the prevalence of trauma symptoms among women in SUD treatment.
创伤事件史（ETE）在物质使用障碍（SUD）治疗中的女性中很常见，且与渴望有关。我们研究了童年期、成年期或两者都有的 ETE（即情感、身体、性虐待）是否通过创伤症状与渴望有关，以及特质正念如何减轻这种关联。
使用了一项针对 SUD 治疗中女性的基于正念的干预的更大随机临床试验的基线数据（N=245）。纳入标准为：18-65 岁，物质使用障碍诊断，英语流利，无认知障碍，愿意接受音频记录并同意。通过面对面访谈收集人口统计学资料和经过验证的 ETE、创伤后应激症状、特质正念和物质使用渴望的测量值。进行描述性统计、相关分析以及直接、间接和条件间接效应模型的相对效应。
大多数参与者为西班牙裔（58.5%），至少受过高中教育（52.2%），平均年龄为 32.2 岁。女性报告称仅在童年期（20.4%）、成年期（17.5%）、童年期和成年期均有暴露（50.0%）或从未有过暴露（11.4%）。与仅在童年期有 ETE 的女性相比，仅在成年期有 ETE（β=-.10，95%CI=-.20，-.02）或无 ETE（β=-.11，95%CI=-.23，-.03；[∆R.347，F(8, 245)=15.7，p<.001）的女性通过降低创伤症状来降低渴望，但与仅在童年期有 ETE 的女性相比没有差异。觉察地行动调节了这种间接效应（∆R=.04，F(3, 245)=4.66，p=.004。在觉察水平较低的情况下，童年期和成年期均有 ETE 的女性通过创伤症状报告的渴望高于无暴露或仅成年期暴露的女性。
低水平的觉察地行动可能会使 ETE 后的创伤症状恶化，进而导致物质使用治疗中的女性更渴望。尽管调节效应的效应量较小，但由于 SUD 治疗中的女性普遍存在创伤症状，因此觉察地行动可能具有临床意义。
