Binge drinking following residential treatment for posttraumatic stress disorder among veterans with and without alcohol use disorder.
Binge drinking following residential treatment for posttraumatic stress disorder among veterans with and without alcohol use disorder.
复制标题
有或没有酒精使用障碍的退伍军人在接受创伤后应激障碍住院治疗后酗酒。
DOI：
10.1016/j.jpsychires.2021.09.024
复制
发表时间：
2021
影响因子：
4.8
通讯作者：
Harpaz-Rotem,Ilan
中科院分区：
文献类型：
--
作者：
Meshberg-Cohen,Sarah;Gross,GeorginaM;Kachadourian,LorigK;Harpaz-Rotem,Ilan
创伤后应激障碍(PTSD)是由高问题饮酒率和共病酒精使用障碍(AUD)引起的。这项研究调查了寻求住院式PTSD治疗的退伍军人，比较了患有和不患有AUD的退伍军人，以确定治疗期间创伤类型和/或PTSD症状的变化是否与4个月后酗酒有关。分析比较了退伍军人(N=10758)住院治疗的特征，以及人口统计、创伤和酒精相关变量与后续酗酒事件的关系。结果表明，基于AUD诊断的PTSD症状改善没有差异。在确诊为AUD的退伍军人中，21.3%的人支持暴饮4天或以上(14.3%的人支持9天或以上)，而在没有AUD的退伍军人中，约10.8%的人在随访时支持暴饮4天或以上(5.2%的人支持9天或以上)。在被诊断为AUD的退伍军人中，虽然创伤后应激障碍症状的改善与酗酒结果无关，但入院时饮酒天数和军中性创伤(MST)预测酗酒的可能性更大。在没有AUD的退伍军人中，入院时饮酒天数、创伤后应激障碍症状增加、未婚、其他种族和受教育程度较低与酗酒的可能性较高有关，而MST和战斗暴露预测酗酒的可能性较低。总而言之，入院时饮酒天数是治疗后酗酒的预测指标；因此，应该在饮酒时评估饮酒情况，并在那些支持饮酒的人中进行处理，以减少住院治疗后恢复饮酒的可能性。此外，在被诊断为AUD的退伍军人中，尽管创伤后应激障碍症状在治疗过程中有所减少，但MST预测在后续的9天或更长时间内狂饮的可能性更大。
Posttraumatic stress disorder (PTSD) is complicated by high rates of problematic drinking and comorbid alcohol use disorder (AUD). This study examined veterans seeking residential PTSD treatment, comparing those with and without AUD, to determine whether trauma type and/or PTSD symptom changes during treatment were associated with binge drinking at 4-month follow-up. Analyses compared characteristics of veterans (N= 758) in residential treatment, as well as associations of demographic, trauma, and alcohol-related variables, with binge drinking episodes at follow-up. Results showed no differences in PTSD symptom improvements based on AUD diagnosis. Among AUD-diagnosed veterans, 21.3% endorsed binge drinking 4 or more (14.3% endorsed 9 or more) days, while 10.8% of veterans without AUD endorsed binge drinking 4 or more (5.2% endorsed 9 or more) days at follow-up. Among AUD-diagnosed veterans, while PTSD symptom improvements were not associated with binge drinking outcomes, drinking days at admission and military sexual trauma (MST) predicted a greater likelihood of binge drinking. Among veterans without AUD, drinking days at admission, PTSD symptom increases, being unmarried, ‘other’ race, and less education, were associated with a higher likelihood of binge drinking, while MST and combat exposure predicted a lower likelihood of binge drinking. In conclusion, drinking days at admission is a predictor of binge drinking following treatment; thus, alcohol use should be assessed at intake and addressed among those who endorse drinking to reduce the likelihood of alcohol resumption following residential treatment. Furthermore, among AUD-diagnosed veterans, despite PTSD symptom decreases during treatment, MST predicted a greater likelihood of 9 or more binge drinking days at follow-up.