前瞻性关联焦虑敏感、不适耐受、抑郁症状以及退伍军人的酒精和大麻使用指标。
Prospective Associations Between Anxiety Sensitivity, Distress Intolerance, Depressive Symptoms, and Indices of Alcohol and Cannabis Use Among Veterans.
机构信息
VA Boston Healthcare System, Boston, Massachusetts.
Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island.
出版信息
J Stud Alcohol Drugs. 2023 Jul;84(4):535-545. doi: 10.15288/jsad.22-00257. Epub 2023 Apr 19.
OBJECTIVE
There is substantial evidence linking anxiety sensitivity and distress intolerance to depressive symptoms, and further evidence linking depressive symptoms to alcohol and cannabis use. However, the prospective indirect associations of anxiety sensitivity and distress intolerance with alcohol and cannabis use through depressive symptoms remain uncertain. Thus, the current study examined whether depressive symptoms mediated the associations between anxiety sensitivity and distress intolerance with alcohol and cannabis use frequency, quantity, and problems in a longitudinal sample of veterans.
METHOD
Participants ( = 361; 93% male; 80% White) were military veterans with lifetime cannabis use recruited from a Veterans Health Administration in the Northeastern United States. Eligible veterans completed three semi-annual assessments. Prospective mediation models were used to test for the effects of baseline anxiety sensitivity and distress intolerance on alcohol and cannabis use quantity, frequency and problems at 12 months via depressive symptoms at 6 months.
RESULTS
Baseline anxiety sensitivity was positively associated with 12-month alcohol problems. Baseline distress intolerance was positively associated with 12-month cannabis use frequency and quantity. Baseline anxiety sensitivity and distress intolerance significantly predicted increased alcohol problems and cannabis use frequency at 12 months through depressive symptoms at 6 months. There were no significant indirect effects of anxiety sensitivity and distress intolerance on alcohol use frequency or quantity, cannabis use quantity, or cannabis problems.
CONCLUSIONS
Anxiety sensitivity and distress intolerance share a common pathway to alcohol problems and cannabis use frequency through depressive symptoms. Interventions focused on modulating negative affectivity may reduce cannabis use frequency and alcohol problems.
目的
有大量证据表明焦虑敏感和痛苦不耐受与抑郁症状有关，进一步的证据表明抑郁症状与酒精和大麻使用有关。然而，焦虑敏感和痛苦不耐受通过抑郁症状与酒精和大麻使用之间的前瞻性间接关联仍不确定。因此，本研究在一个纵向的退伍军人样本中，检验了抑郁症状是否在焦虑敏感和痛苦不耐受与酒精和大麻使用频率、数量和问题之间起中介作用。
方法
参与者（n=361；93%为男性；80%为白人）为来自美国东北部退伍军人健康管理局的有终身大麻使用史的退伍军人。符合条件的退伍军人完成了三次半年评估。前瞻性中介模型用于检验基线焦虑敏感和痛苦不耐受对 6 个月时抑郁症状的 12 个月时酒精和大麻使用量、频率和问题的影响。
结果
基线焦虑敏感与 12 个月时的酒精问题呈正相关。基线痛苦不耐受与 12 个月时的大麻使用频率和数量呈正相关。基线焦虑敏感和痛苦不耐受通过 6 个月时的抑郁症状显著预测了 12 个月时酒精问题和大麻使用频率的增加。焦虑敏感和痛苦不耐受对酒精使用频率或数量、大麻使用数量或大麻问题没有显著的间接影响。
结论
焦虑敏感和痛苦不耐受通过抑郁症状共享一条共同途径导致酒精问题和大麻使用频率增加。针对调节负性情感的干预措施可能会减少大麻使用频率和酒精问题。
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