Negative affect and alcohol craving in trauma-exposed young adult drinkers.
Negative affect and alcohol craving in trauma-exposed young adult drinkers.
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DOI：
10.1111/acer.14641
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Ranney R
中科院分区：
文献类型：
--
作者：
Berenz EC;Edalatian Zakeri S;Demos AP;Paltell KC;Bing-Canar H;Kevorkian S;Ranney R
临床研究表明，创伤后应激障碍（PTSD）的成功治疗并不会改善共病PTSD和酒精使用障碍（AUD）患者的酒精使用结果。新出现的理论认为，治疗PTSD可能不会破坏负面情绪与酒精渴望之间的关联，而这种关联是负强化饮酒的基础。本研究的目的是确定PTSD症状、应对动机和负面情绪对创伤和酒精线索反应性的各自影响，以便为共病PTSD和AUD的理论模型提供信息。
样本包括189名年轻成年人（50.3%为女性；49.2%目前患有PTSD；84.0%目前患有AUD），他们都承认有人际创伤（如性侵犯/身体攻击）且目前每周饮酒。参与者完成了一项创伤和酒精线索反应性评估，在此过程中，针对4种叙述性（即个性化创伤或标准中性）和体内饮料（即个性化酒精或水）线索组合，记录了主观（如渴望、情绪）和生理（即唾液分泌）指标。
正向拟合线性混合效应（LME）模型证实，在PTSD症状高而非低的人群中，创伤线索引发的渴望升高，这与先前的研究和理论一致。创伤线索引发的渴望完全由负面情绪的增加所解释，没有证据表明创伤线索对渴望有直接影响。PTSD症状调节了创伤线索与负面情绪之间的关联（但不是负面情绪与渴望之间的关联），酒精应对动机调节了负面情绪与渴望之间的关联（但不是创伤线索与负面情绪之间的关联）。
这项研究为负面情绪、PTSD症状和应对动机对遭受创伤的饮酒者的酒精渴望的各自贡献提供了新的实验室证据。它提供了一个方法框架，用于评估旨在破坏共病PTSD和AUD个体的负强化饮酒的新策略。
Clinical research indicates that successful posttraumatic stress disorder (PTSD) treatment does not lead to improvements in alcohol use outcomes in comorbid PTSD and alcohol use disorder (AUD). Emerging theory suggests that treating PTSD may not disrupt an association between negative affect and alcohol craving, which underlies negative reinforcement drinking. The goal of the current study was to determine the respective influences of PTSD symptoms, coping motives, and negative affect on trauma and alcohol cue reactivity to inform theoretical models of co-occurring PTSD and AUD. The sample consisted of 189 young adults (50.3% women; 49.2% current PTSD; 84.0% current AUD) who endorsed interpersonal trauma (e.g., sexual/physical assault) and current weekly alcohol use. Participants completed a trauma and alcohol cue reactivity assessment, in which subjective (e.g., craving, affect) and physiological (i.e., salivation) measures were recorded in response to 4 narrative (i.e., personalized trauma or standard neutral) and in vivo beverage (i.e., personalized alcohol or water) cue combinations. Forward-fitted linear mixed-effects (LME) models confirmed that trauma cue–elicited craving was elevated among those high but not low in PTSD symptoms, consistent with prior research and theory. Trauma cue–elicited craving was fully explained by increases in negative affect, with no evidence of a direct effect of trauma cue on craving. PTSD symptoms moderated an association between trauma cue and negative affect (but not negative affect and craving), and coping motives for alcohol moderated an association between negative affect and craving (but not trauma cue and negative affect). This study provides novel laboratory evidence for the respective contributions of negative affect, PTSD symptoms, and coping motives on alcohol craving in trauma-exposed drinkers. It offers a methodological framework in which to evaluate novel strategies that aim to disrupt negative reinforcement drinking in individuals with co-occurring PTSD and AUD.
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