感知应激在童年期虐待与酒精使用障碍严重程度关系中的作用：一项中介分析
The Role of Perceived Stress in the Relation between Childhood Maltreatment and Severity of Alcohol Use Disorder: A Mediation Analysis.
作者信息
Bougelet Emilie, Deffaa Mirjam, Türkmen Cagdas, Kiefer Falk, Vollstädt-Klein Sabine, Gerhardt Sarah
机构信息
Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany.
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
出版信息
Eur Addict Res. 2024;30(6):347-356. doi: 10.1159/000539711. Epub 2024 Jul 17.
INTRODUCTION
Experiences of Childhood Maltreatment (CM) relate to relapse and lower treatment success in Alcohol Use Disorder (AUD), one of the most prevalent substance use disorders. However, the exact mechanisms of this relationship still remain unclear. This study examines perceived stress and "drinking to cope with negative affect" (coping) as possible mediators in this relationship. Moreover, it aims at uncovering the differential effects of the subtypes of CM.
METHODS
N = 96 individuals (42% women; mean age 41 ± 13 years) including healthy controls and individuals with varying severity of AUD and CM completed the Alcohol-Dependence Scale, Childhood Trauma Questionnaire, Perceived Stress Scale and German Inventory of Drinking Situations. Mediation analyses including perceived stress as a mediator between CM (and subtypes) and severity of AUD, as well as a serial mediation of the relationship between CM and AUD severity by perceived stress and coping were conducted.
RESULTS
Perceived stress significantly mediated the relation between CM and AUD severity and the serial mediation by perceived stress and coping turned out significant. Subtype-specific analyses did not yield significant results.
CONCLUSION
This study reinforces perceived stress as a potential mechanism in the relation between CM and AUD severity. Moreover, coping further mediated the relationship between CM and AUD severity. Our results suggest including screening for CM (subtypes) in clinical routine in order to individually emphasize interventions focusing on stress regulation, as well as on developing healthy coping mechanisms, in patients with AUD. This might prevent heightened stress sensitivity, relapse and further maintenance of AUD.
INTRODUCTION
Experiences of Childhood Maltreatment (CM) relate to relapse and lower treatment success in Alcohol Use Disorder (AUD), one of the most prevalent substance use disorders. However, the exact mechanisms of this relationship still remain unclear. This study examines perceived stress and "drinking to cope with negative affect" (coping) as possible mediators in this relationship. Moreover, it aims at uncovering the differential effects of the subtypes of CM.
METHODS
N = 96 individuals (42% women; mean age 41 ± 13 years) including healthy controls and individuals with varying severity of AUD and CM completed the Alcohol-Dependence Scale, Childhood Trauma Questionnaire, Perceived Stress Scale and German Inventory of Drinking Situations. Mediation analyses including perceived stress as a mediator between CM (and subtypes) and severity of AUD, as well as a serial mediation of the relationship between CM and AUD severity by perceived stress and coping were conducted.
RESULTS
Perceived stress significantly mediated the relation between CM and AUD severity and the serial mediation by perceived stress and coping turned out significant. Subtype-specific analyses did not yield significant results.
CONCLUSION
This study reinforces perceived stress as a potential mechanism in the relation between CM and AUD severity. Moreover, coping further mediated the relationship between CM and AUD severity. Our results suggest including screening for CM (subtypes) in clinical routine in order to individually emphasize interventions focusing on stress regulation, as well as on developing healthy coping mechanisms, in patients with AUD. This might prevent heightened stress sensitivity, relapse and further maintenance of AUD.
引言
童年虐待经历（CM）与酒精使用障碍（AUD，最常见的物质使用障碍之一）的复发及较低的治疗成功率相关。然而，这种关系的确切机制仍不清楚。本研究考察感知压力和“借酒应对负面情绪”（应对方式）作为这种关系中可能的中介因素。此外，其旨在揭示CM各亚型的不同影响。
方法
96名个体（42%为女性；平均年龄41±13岁），包括健康对照者以及患有不同严重程度AUD和CM的个体，完成了酒精依赖量表、童年创伤问卷、感知压力量表和德国饮酒情境量表。进行了中介分析，包括将感知压力作为CM（及其亚型）与AUD严重程度之间的中介，以及由感知压力和应对方式对CM与AUD严重程度之间关系进行的系列中介分析。
结果
感知压力显著中介了CM与AUD严重程度之间的关系，且由感知压力和应对方式进行的系列中介分析结果显著。亚型特异性分析未得出显著结果。
结论
本研究强化了感知压力是CM与AUD严重程度之间关系的一种潜在机制这一观点。此外，应对方式进一步中介了CM与AUD严重程度之间的关系。我们的结果表明，在临床常规中应纳入对CM（各亚型）的筛查，以便针对AUD患者个体着重强调聚焦于压力调节以及培养健康应对机制的干预措施。这可能预防压力敏感性增加、复发及AUD的进一步持续存在。
引言
童年虐待经历（CM）与酒精使用障碍（AUD，最常见的物质使用障碍之一）的复发及较低的治疗成功率相关。然而，这种关系的确切机制仍不清楚。本研究考察感知压力和“借酒应对负面情绪”（应对方式）作为这种关系中可能的中介因素。此外，其旨在揭示CM各亚型的不同影响。
方法
96名个体（42%为女性；平均年龄41±13岁），包括健康对照者以及患有不同严重程度AUD和CM的个体，完成了酒精依赖量表、童年创伤问卷、感知压力量表和德国饮酒情境量表。进行了中介分析，包括将感知压力作为CM（及其亚型）与AUD严重程度之间的中介，以及由感知压力和应对方式对CM与AUD严重程度之间关系进行的系列中介分析。
结果
感知压力显著中介了CM与AUD严重程度之间的关系，且由感知压力和应对方式进行的系列中介分析结果显著。亚型特异性分析未得出显著结果。
结论
本研究强化了感知压力是CM与AUD严重程度之间关系的一种潜在机制这一观点。此外，应对方式进一步中介了CM与AUD严重程度之间的关系。我们的结果表明，在临床常规中应纳入对CM（各亚型）的筛查，以便针对AUD患者个体着重强调聚焦于压力调节以及培养健康应对机制的干预措施。这可能预防压力敏感性增加、复发及AUD的进一步持续存在。
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