Daily associations between PTSD, drinking, and self-appraised alcohol-related problems.
Daily associations between PTSD, drinking, and self-appraised alcohol-related problems.
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创伤后应激障碍、饮酒和自我评估的酒精相关问题之间的日常联系。
DOI：
10.1037/adb0000238
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Simpson,TracyL
中科院分区：
文献类型：
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作者：
Wilson,SarahM;Krenek,Marketa;Dennis,PaulA;Yard,SamanthaS;Browne,KendallC;Simpson,TracyL
酒精依赖（AD）和创伤后应激障碍（PTSD）是高度共病的，但对PTSD和日常饮酒的研究有限，因为它们与自我评估的酒精相关问题有关。在治疗环境中，患者对酒精相关问题的评估对评估、干预策略和预后都有影响。本研究调查了PTSD的个人内部（每日症状）和个人之间（总体严重程度）差异对每日饮酒和当日酒精相关问题之间关系的调节作用。同时患有AD和PTSD的参与者（N= 86）完成了为期1周的交互式语音识别数据收集，并使用logistic和γ调整的多水平模型来估计自评酒精相关问题的几率和程度。结果显示，个人内部和个人之间的创伤后应激障碍调节了饮酒量和自我评价问题严重程度之间的关联。随着人与人之间和人与人之间的PTSD症状的增加，饮酒量与感知到的酒精相关问题之间的关联减弱。对比进一步显示，在不饮酒和少量饮酒的日子里，创伤后应激障碍（每日症状和总体严重程度）与酒精相关问题的评分呈正相关。然而，在大量饮酒的日子里，创伤后应激障碍与酒精相关问题无关。总之，更严重的创伤后应激障碍与饮酒量和感知到的酒精相关问题之间不太直接的偶然关系相关。这些发现表明进一步研究这种调节作用的重要性，以及用饮酒功能分析对共病AD和严重PTSD的临床治疗的重要性。
Alcohol dependence (AD) and posttraumatic stress disorder (PTSD) are highly comorbid, yet limited research has focused on PTSD and daily drinking as they relate to self-appraised alcohol-related problems. In treatment contexts, patients’ appraisals of alcohol-related problems have implications for assessment, intervention strategies, and prognosis. This study investigated the moderating effect of within-person (daily symptoms) and between-person (overall severity) differences in PTSD on the association between daily drinking and same-day alcohol-related problems. Participants with comorbid AD and PTSD (N= 86) completed 1 week of Interactive Voice Recognition data collection, and logistic and γ-adjusted multilevel models were used to estimate odds and magnitude of self-appraised alcohol-related problems. Results revealed that both within-person and between-person PTSD moderated the association between number of drinks and severity of self-appraised problems. As within-person and between-person PTSD symptoms increased, there was a weaker association between number of drinks consumed and perceived alcohol-related problems. Contrasts further revealed that on nondrinking and light-drinking days, PTSD (both daily symptoms and overall severity) was positively associated with ratings of alcohol-related problems. However, PTSD was not associated with alcohol-related problems on heavier drinking days. In conclusion, more severe PTSD is associated with a less directly contingent relationship between drinking quantity and perceived alcohol-related problems. These findings suggest the importance of further investigations of this moderating effect as well as clinical treatment of comorbid AD and severe PTSD with functional analysis of drinking.