Coatesville Veterans Affairs Medical Center, Coatesville, PA, USA.
J Dual Diagn. 2022 Jul-Sep;18(3):135-143. doi: 10.1080/15504263.2022.2089799. Epub 2022 Jun 27.
Posttraumatic stress disorder (PTSD) is one of the most frequently treated behavioral health conditions within the Department of Veterans Affairs and often co-occurs with alcohol or substance use. Past research suggests that alcohol and/or substance use may be used to cope with PTSD symptoms but there are inconsistent findings in how specific PTSD symptom clusters are associated with alcohol use disorder (AUD) or substance use disorder (SUD). Evaluating the relationship between PTSD symptom clusters and craving for individual drug of dependence may help explain these ambiguous results. Veterans ( = 167) recently engaged in mental health residential treatment were recruited to participate in a semi-structured diagnostic interview (Structured Clinical Interview for the , Research Version [SCID-5-RV]) to assess for past 12-month history of AUD/SUD. Participants also completed the Posttraumatic Stress Disorder Checklist for (PCL-5) to assess PTSD symptoms. Covarying for severity of alcohol use, avoidance symptoms were significantly associated with alcohol craving for veterans with alcohol as their drug of dependence. Covarying for severity of stimulant use, no PTSD symptom clusters were associated with stimulant craving for veterans with stimulants as their drug of dependence. Veterans with high levels of PTSD avoidance symptoms may experience alcohol craving symptoms because they believe that alcohol use will eliminate or alleviate thoughts, feelings, or external reminders of the trauma. These results have important clinical implications in the treatment of co-occurring PTSD and AUD.
创伤后应激障碍(PTSD)是退伍军人事务部最常治疗的行为健康状况之一,并且经常与酒精或物质使用同时发生。过去的研究表明,酒精和/或物质使用可能被用来应对 PTSD 症状,但特定的 PTSD 症状群与酒精使用障碍(AUD)或物质使用障碍(SUD)之间的关联存在不一致的发现。评估 PTSD 症状群与对个体依赖药物的渴望之间的关系可能有助于解释这些模糊的结果。
最近接受心理健康住院治疗的退伍军人( = 167)被招募参与半结构化诊断访谈(用于研究的 结构临床访谈 [SCID-5-RV]),以评估过去 12 个月 AUD/SUD 的病史。参与者还完成了创伤后应激障碍检查表 5 项版(PCL-5)以评估 PTSD 症状。
在考虑酒精使用严重程度的情况下,回避症状与有酒精依赖的退伍军人的酒精渴望显著相关。在考虑兴奋剂使用严重程度的情况下,没有 PTSD 症状群与有兴奋剂依赖的退伍军人的兴奋剂渴望相关。
回避症状程度较高的 PTSD 退伍军人可能会出现酒精渴望症状,因为他们认为饮酒会消除或减轻对创伤的想法、感受或外部提醒。这些结果在治疗同时发生的 PTSD 和 AUD 方面具有重要的临床意义。