Posttraumatic stress disorder, drinking to cope, and harmful alcohol use: A multivariate meta-analysis of the self-medication hypothesis.
Posttraumatic stress disorder, drinking to cope, and harmful alcohol use: A multivariate meta-analysis of the self-medication hypothesis.
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DOI：
10.1037/abn0000764
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发表时间：
2022-07
期刊：
影响因子：
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通讯作者：
Murphy, James G
中科院分区：
文献类型：
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作者：
Luciano, Matthew T;Acuff, Samuel F;Olin, Cecilia C;Lewin, Rivian K;Strickland, Justin C;McDevitt-Murphy, Meghan E;Murphy, James G
创伤后应激障碍(PTSD)和有害饮酒之间的联系通常通过与应对相关的饮酒动机的自我用药假说来解释。然而，创伤后应激障碍通过应对动机对有害酒精使用的间接影响的程度尚不清楚。本研究采用元分析结构方程模型方法对间接效应进行了汇总，并探索了影响间接效应的调节因素。我们确定了来自JuncINFO、PubMed/MEDLINE和ProQuest(截至2021年6月22日)的文章，其中包含(1)创伤后应激障碍症状，(2)与应对相关的饮酒，以及(3)有害酒精使用。纳入了34项研究，共产生69个效应大小(平均N=387.26名参与者；中位数N=303.5；范围=42-1,896；总样本n=15,128)。应对动机在创伤后应激障碍与有害饮酒之间起中介作用，可解释总效应的80%。调节变量和发表偏向的证据也被发现。研究结果表明，与应对相关的饮酒在创伤后应激障碍和有害饮酒之间的关系中起到了很强的中介作用，而且间接影响的强度受到测量方法、样本特征和研究设计的显著影响。还需要更多的纵向和多变量研究来确定方向性并解释额外的差异。与应对相关的饮酒可以帮助解释创伤后应激障碍和有害饮酒之间的关系。然而，与应对相关的饮酒解释这种关系的程度取决于测量方法、样本特征和研究设计。
The association between posttraumatic stress disorder (PTSD) and harmful alcohol use has often been explained through the self-medication hypothesis via coping-related drinking motives. However, the magnitude of the indirect effect of PTSD on harmful alcohol use through coping motives is unclear. This study aggregated this indirect effect using a meta-analytic structural equation modeling approach and explored moderators that influenced the indirect effect. We identified articles from PsycINFO, PubMed/MEDLINE, and PROQUEST (through 22 June 2021) containing measures of (1) PTSD symptoms, (2) coping-related drinking, and (3) harmful alcohol use. Thirty-four studies yielding 69 effect sizes were included (mean N = 387.26 participants; median N = 303.5; range = 42 – 1,896; aggregate sample n = 15,128). Coping motives mediated the relation between PTSD and harmful alcohol use, accounting for 80% of the variance in the total effect. Moderating variables and evidence of publication bias were also found. Findings suggest that coping-related drinking is a strong mediator in the relation between PTSD and harmful alcohol use, and that the strength of the indirect effect is meaningfully influenced by measurement approach, sample characteristics, and study design. Additional longitudinal and multivariate studies are needed to establish directionality and account for additional variance. Coping-related drinking can help explain the relationship between PTSD and harmful alcohol use. However, the degree to which coping-related drinking explains this relationship depends on the measurement approach, sample characteristics, and study design.