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物质使用障碍中的创伤经历和创伤后应激障碍症状:康复者与当前使用者的比较。

Traumatic experiences and PTSD symptoms in substance use disorder: A comparison of recovered versus current users.

作者信息

Belfrage Anna, Mjølhus Njå Anne Lill, Lunde Siri, Årstad Janne, Fodstad Elise Constance, Lid Torgeir Gilje, Erga Aleksander Hagen

机构信息

Center for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway.

Center for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway; and Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Norway.

出版信息

Nordisk Alkohol Nark. 2023 Feb;40(1):61-75. doi: 10.1177/14550725221122222. Epub 2022 Nov 4.


DOI:10.1177/14550725221122222
PMID:36793481
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9893129/
Abstract

The aim of this study was to investigate the prevalence of traumatic experiences and symptoms of posttraumatic stress disorder (PTSD) in treatment-seeking individuals with ongoing substance use disorder (SUD) compared to individuals who have recovered from SUD. Patients with SUD recruited from the STAYER study (N = 114) underwent an examination of alcohol and drug use, childhood trauma, negative life events and PTSD symptomatology. In this study, only participants with 12-month concurrent polysubstance use was included. Using historical data from the STAYER study, alcohol and drug trajectories were dichotomised as (1) current SUD (current SUD) or (2) recovered from substance use disorder (recovered SUD). Crosstabs and chi-tests were used to measure differences between groups. Childhood maltreatment, traumatic experiences later in life and symptoms of concurrent PTSD were highly prevalent in the study population. We found no significant difference between the current and recovered SUD groups. Recovered women reported a lower prevalence of physical neglect ( = 0.031), but a higher prevalence of multiple lifetime traumas ( = 0.019) compared to women with current SUD. Both women with current SUD and recovered women reported a significantly higher prevalence of sexual aggression than men ( < 0.001 and < 0.001, respectively). In addition, men who have recovered from SUD reported a lower prevalence of PTSD symptoms over cut-off 38 ( = 0.017), of re-experiencing ( = 0.036) and of avoidance ( = 0.015), compared to recovered women. Reported trauma did not differ between persons with current SUD and those who had recovered from SUD. Gender differences discovered in this study indicate the importance of developing individualised and gender-specific treatment models for comorbid PTSD/SUD.

摘要

本研究的目的是调查正在接受治疗的患有持续性物质使用障碍(SUD)的个体与已从SUD中康复的个体相比,创伤经历和创伤后应激障碍(PTSD)症状的患病率。从“STAYER研究”中招募的患有SUD的患者(N = 114)接受了酒精和药物使用、童年创伤、负面生活事件以及PTSD症状学的检查。在本研究中,仅纳入了有12个月同时使用多种物质情况的参与者。利用“STAYER研究”的历史数据,将酒精和药物使用轨迹分为两类:(1)当前SUD(当前SUD)或(2)已从物质使用障碍中康复(已康复SUD)。使用交叉表和卡方检验来衡量组间差异。童年虐待、成年后的创伤经历以及并发PTSD的症状在研究人群中非常普遍。我们发现当前SUD组和已康复SUD组之间没有显著差异。与当前患有SUD的女性相比,已康复的女性报告的身体忽视患病率较低(P = 0.031),但多次终身创伤的患病率较高(P = 0.019)。当前患有SUD的女性和已康复的女性报告的性侵犯患病率均显著高于男性(分别为P < 0.001和P < 0.001)。此外,与已康复的女性相比,已从SUD中康复的男性报告的PTSD症状超过临界值38的患病率较低(P = 0.017),重新体验症状的患病率较低(P = 0.036),回避症状的患病率较低(P = 0.015)。当前患有SUD的人与已从SUD中康复的人报告的创伤情况没有差异。本研究中发现的性别差异表明,针对共病PTSD/SUD制定个性化和针对性别的治疗模式非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de83/9893129/1a36367cba4d/10.1177_14550725221122222-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de83/9893129/9cecffd2342d/10.1177_14550725221122222-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de83/9893129/68da2b05a097/10.1177_14550725221122222-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de83/9893129/1a36367cba4d/10.1177_14550725221122222-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de83/9893129/9cecffd2342d/10.1177_14550725221122222-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de83/9893129/68da2b05a097/10.1177_14550725221122222-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de83/9893129/1a36367cba4d/10.1177_14550725221122222-fig3.jpg

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[6]
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[8]
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本文引用的文献

[1]
Prevalence and Characteristics of Borderline Intellectual Functioning in a Cohort of Patients With Polysubstance Use Disorder.

Front Psychiatry. 2021-7-14

[2]
Prevalence of childhood trauma measured by the short form of the Childhood Trauma Questionnaire in people with substance use disorder: A meta-analysis.

Psychiatry Res. 2020-12

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Front Neurosci. 2020-6-16

[4]
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Front Psychiatry. 2019-8-27

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Addiction. 2017-11-24

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Child Abuse Negl. 2017-5-15

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Eur J Psychotraumatol. 2016-4-19

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Clin Psychol (New York). 2012-9-1

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