Vigfusdottir Johanna, Breivik Edvard, Henden Bjorn Olav, Jonsbu Egil, Lien Lars, Stenmark Hakon, Mork Erlend
Department of Psychiatry, More and Romsdal Hospital Trust, Ålesund, Norway.
Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
Eur J Psychotraumatol. 2025 Dec;16(1):2509385. doi: 10.1080/20008066.2025.2509385. Epub 2025 Jun 5.
Individuals with substance use disorder (SUD) often struggle significantly with regulating their emotions and there is a high prevalence of a history of exposure to traumatic events. Difficulties in emotion regulation and PTSD symptom severity contribute to elevated psychological burden, higher dropout rates, and increased risk of relapse. Currently, we still lack a precise understanding of the psychological mechanisms associated with difficulties in emotion regulation in SUD. The objective of this study was to examine the magnitude and correlates of difficulties in emotion regulation among patients with SUD who have a history of exposure to traumatic events. We assessed the association between difficulties in emotion regulation and PTSD symptoms, emotional avoidance, shame, guilt, and substance use-related problems. This cross-sectional observational study was conducted in a naturalistic setting with 74 adult patients in long-term inpatient SUD treatment in Norway, including both sexes. A clinical interview measuring PTSD symptom severity was conducted and participants completed questionnaires about emotion regulation, emotional avoidance, shame, guilt, and substance use-related problems. Additional demographical and descriptive data were collected. The patients reported substantial difficulties in emotion regulation, severe PTSD symptoms, severe emotional avoidance, and strong shame and guilt. Emotional avoidance and shame but not guilt or alcohol or substance use-related problems were associated with greater difficulties in emotion regulation beyond the difficulties contributed by PTSD symptom severity. Difficulties in emotion regulation were highly prevalent in this sample. The findings support targeting difficulties in emotion regulation, emotional avoidance, and shame especially in long-term SUD treatment for patients with a history of exposure to traumatic events. Reducing these factors may help potentially improve treatment outcomes and reduce suffering for this difficult-to-treat patient population.
患有物质使用障碍（SUD）的个体在情绪调节方面往往存在显著困难，且有很高比例的人有过创伤事件暴露史。情绪调节困难和创伤后应激障碍（PTSD）症状的严重程度会导致心理负担加重、更高的辍学率以及复发风险增加。目前，我们仍缺乏对SUD中与情绪调节困难相关的心理机制的精确理解。本研究的目的是检验有创伤事件暴露史的SUD患者情绪调节困难的程度及其相关因素。我们评估了情绪调节困难与PTSD症状、情绪回避、羞耻感、内疚感以及与物质使用相关问题之间的关联。这项横断面观察性研究在挪威对74名接受长期住院SUD治疗的成年患者（包括男性和女性）进行了自然环境下的调查。进行了一项测量PTSD症状严重程度的临床访谈，参与者完成了关于情绪调节、情绪回避、羞耻感、内疚感以及与物质使用相关问题的问卷。还收集了额外的人口统计学和描述性数据。患者报告在情绪调节方面存在严重困难、PTSD症状严重、情绪回避严重以及有强烈的羞耻感和内疚感。除了PTSD症状严重程度所导致的困难外，情绪回避和羞耻感而非内疚感或与酒精或物质使用相关的问题与更大的情绪调节困难相关。情绪调节困难在该样本中非常普遍。研究结果支持针对情绪调节困难、情绪回避和羞耻感进行干预，尤其是对有创伤事件暴露史的患者进行长期SUD治疗。减少这些因素可能有助于潜在地改善治疗效果并减轻这一难以治疗的患者群体的痛苦。
