Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA.
Department of Physical Medicine and Rehabilitation, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.
Subst Use Misuse. 2024;59(13):1895-1900. doi: 10.1080/10826084.2024.2383979. Epub 2024 Aug 5.
One in five college students (21%) report using cannabis in the past month, and approximately 10% develop cannabis use disorder (CUD). Further, college students have high rates of trauma exposure, and CUD is prospectively linked to posttraumatic stress disorder (PTSD). Given the high rate of co-occurrence, research is needed to understand transdiagnostic, modifiable factors that could account for the relationship between CUD and PTSD. Psychological inflexibility (PI) is one such factor and refers to difficulty adapting thoughts or behaviors to various situations that reflect of one's personal values. PI predicts worse PTSD symptom severity and has been established as a maintaining factor between alcohol use and PTSD, albeit no studies have examined this relationship with CUD. College students ( = 336) completed self-report measures of CUD, PI, and PTSD. A cross-sectional mediation model explained 54% of the variance in PTSD symptom severity, (5, 330) = 78.86, p < .001. After controlling for age, gender, and probable alcohol use disorder, CUD was not directly associated with PTSD symptom severity, yet was indirectly associated with PTSD through higher PI. Specifically, CUD was associated with higher PI ( = 0.31, < .05, 95% CI [0.07, 0.54]), and higher PI was associated with greater PTSD symptom severity ( = 1.07, < .001, 95% CI [0.95, 1.19]). Although CUD has been previously linked with worse PTSD symptoms, results suggest that this occurs through PI. Importantly, PI is malleable, and may be an important treatment target for co-occurring CUD and PTSD in college students.
五分之一的大学生（21%）报告在过去一个月中使用大麻，约 10%的大学生患有大麻使用障碍（CUD）。此外，大学生有很高的创伤暴露率，CUD 与创伤后应激障碍（PTSD）呈前瞻性相关。鉴于共病率较高，需要研究理解可能解释 CUD 和 PTSD 之间关系的跨诊断、可改变的因素。心理不灵活性（PI）就是这样一个因素，它指的是难以根据个人价值观来调整思想或行为以适应各种情况。PI 预测 PTSD 症状严重程度更差，并且已经被确立为酒精使用和 PTSD 之间的维持因素，尽管没有研究检验过它与 CUD 的关系。336 名大学生完成了大麻使用障碍、PI 和 PTSD 的自我报告测量。一个横断面中介模型解释了 PTSD 症状严重程度的 54%的方差，（5, 330）= 78.86，p <.001。在控制年龄、性别和可能的酒精使用障碍后，CUD 与 PTSD 症状严重程度没有直接关联，而是通过更高的 PI 与 PTSD 间接相关。具体来说，CUD 与更高的 PI 相关（ = 0.31，<.05，95%置信区间 [0.07, 0.54]），而更高的 PI 与更大的 PTSD 症状严重程度相关（ = 1.07，<.001，95%置信区间 [0.95, 1.19]）。尽管 CUD 以前与更严重的 PTSD 症状相关，但结果表明这是通过 PI 发生的。重要的是，PI 是可塑的，并且可能是大学生中同时患有 CUD 和 PTSD 的重要治疗靶点。
