Evaluating the influences of major depression and posttraumatic stress disorder on trauma and alcohol cue reactivity.
Evaluating the influences of major depression and posttraumatic stress disorder on trauma and alcohol cue reactivity.
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DOI：
10.1016/j.addbeh.2020.106596
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发表时间：
2021-01
影响因子：
4.4
通讯作者：
Berenz EC
中科院分区：
文献类型：
--
作者：
Bing-Canar H;Demos A;Mermelstein RJ;Berenz EC
尽管有观点支持自我用药式饮酒在共病创伤后应激障碍（PTSD）和酒精使用障碍（AUD）的病因及维持方面的作用，但PTSD - AUD的理论和实证模型很少考虑常见共病在风险过程中的作用，比如重性抑郁障碍（MDD）。当前的研究检验了PTSD和抑郁症状对创伤模式以及酒精线索反应性的主效应和交互效应，以阐明抑郁对创伤记忆的条件性渴求反应的潜在影响。据推测，在PTSD症状的影响之外，抑郁症状与对个性化创伤线索更强的线索反应性（即渴求及唾液分泌）相关。参与者是184名有创伤经历的年轻人（50%为女性），他们认可目前每周饮酒。针对叙述（创伤与中性）和饮品（酒精与水）线索的四种组合，对渴求及唾液分泌模式进行了评估。采用偏差检验的正向拟合线性混合效应模型，以确定受试者内因素（叙述和饮品线索）以及协变量（PTSD和抑郁症状）对自我报告的以及生理（唾液分泌）层面的酒精渴求的影响。抑郁症状在基线水平与饮酒应对动机增强、AUD症状严重程度以及酒精使用问题相关；然而，抑郁症状在预测渴求或唾液分泌方面，与叙述或饮品线索没有显示出主效应或交互效应，p值＞0.05。结果表明，在PTSD症状的背景下，抑郁症状可能不会加剧对创伤提醒或酒精线索的酒精渴求反应。
Despite support for the role of self-medication alcohol use in the etiology and maintenance of comorbid posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD), theoretical and empirical models of PTSD-AUD rarely account for the role of common comorbidities in risk processes, such as major depressive disorder (MDD). The current study examined the main and interactive effects of PTSD and depressive symptoms on patterns of trauma and alcohol cue reactivity to elucidate potential influences of depression on conditioned craving responses to trauma memories. It was hypothesized that depressive symptoms would be associated with greater cue reactivity (i.e., craving and salivation) to personalized trauma cues, above and beyond the influence of PTSD symptoms. Participants were 184 trauma-exposed young adults (50% female) endorsing current weekly alcohol use. Patterns of craving and salivation were assessed in response to four combinations of narrative (trauma vs. neutral) and beverage (alcohol vs. water) cues. Forward-fitted linear mixed effects models with deviance testing were conducted to ascertain the impact of the within-subjects factors (narrative and beverage cues) and covariates (PTSD and depressive symptoms) on self-reported and physiological (salivation) alcohol craving. Depressive symptoms were associated with elevated drinking coping motives, AUD symptom severity, and alcohol use problems at baseline; however, depressive symptoms did not show main or interactive effects with narrative or beverage cues to predict craving or salivation, p’s > .05. Results suggest that, in the context of PTSD symptoms, depressive symptoms may not exacerbate alcohol craving responses to trauma reminders or alcohol cues.
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