Karnick Aleksandr T, Buerke Morgan, Caulfied Nicole, Trussell Dylan, Capron Daniel W, Vujanovic Anka
Department of Psychology, University of Southern Mississippi, Hattiesburg, MS 39402, USA.
Department of Psychology, University of Southern Mississippi, Hattiesburg, MS 39402, USA.
Drug Alcohol Depend. 2022 Dec 1;241:109677. doi: 10.1016/j.drugalcdep.2022.109677. Epub 2022 Oct 29.
Firefighters are at heightened risk for developing alcohol use disorder (AUD), possibly due to chronic stress and exposure to potentially traumatic events. Daily trauma experiences and transdiagnostic risk factors (i.e., anxiety sensitivity and distress intolerance) are related to posttraumatic stress and depressive symptoms, as well as alcohol use severity and alcohol as a coping strategy. Although alcohol use has been identified as a key target for addressing mental health in firefighters, prior research has not fully integrated transdiagnostic vulnerabilities, internalizing symptoms, posttraumatic stress symptoms, alcohol coping, and overall alcohol use into a dynamic network model.
We assessed the symptom structure of overall alcohol use in firefighters with a likely AUD and transdiagnostic risk factors in all firefighters using network analysis.
Failing to meet expectations (Expected Influence [EI]: 1.32), morning dependence (EI: 1.07), and guilt about drinking (EI: 1.10) were most central to the network model developed for firefighters with a likely AUD. In a transdiagnostic model of use in firefighters overall, anxiety sensitivity cognitive concerns (EI: 1.48) and negative alterations to cognitions and mood related to trauma (EI: 1.87) had the highest influence on the network. Notable correlations were also identified between trauma arousal and overall alcohol use, between depression and alcohol coping motives, and between trauma avoidance and alcohol coping motives.
Alcohol use behaviors may follow a unique etiologic pathway in firefighters and intervention strategies should target factors found to be more central to symptom networks.
消防员患酒精使用障碍（AUD）的风险较高，这可能是由于长期压力以及接触潜在创伤性事件所致。日常创伤经历和跨诊断风险因素（即焦虑敏感性和痛苦不耐受）与创伤后应激症状和抑郁症状相关，也与酒精使用严重程度以及将酒精作为一种应对策略有关。尽管酒精使用已被确定为解决消防员心理健康问题的关键目标，但先前的研究尚未将跨诊断易感性、内化症状、创伤后应激症状、酒精应对方式以及总体酒精使用情况完全整合到一个动态网络模型中。
我们使用网络分析评估了可能患有酒精使用障碍的消防员的总体酒精使用症状结构以及所有消防员的跨诊断风险因素。
对于可能患有酒精使用障碍的消防员所构建的网络模型，未达到期望（预期影响[EI]：1.32）、早晨依赖（EI：1.07）以及饮酒内疚感（EI：1.10）在其中最为核心。在消防员总体使用情况的跨诊断模型中，焦虑敏感性认知担忧（EI：1.48）以及与创伤相关的认知和情绪的消极改变（EI：1.87）对该网络的影响最大。还发现创伤唤醒与总体酒精使用之间、抑郁与酒精应对动机之间以及创伤回避与酒精应对动机之间存在显著相关性。
酒精使用行为在消防员中可能遵循独特的病因路径，干预策略应针对那些在症状网络中更为核心的因素。
