Influence of PTSD symptom clusters on smoking status among help-seeking Iraq and Afghanistan veterans
Influence of PTSD symptom clusters on smoking status among help-seeking Iraq and Afghanistan veterans
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DOI：
10.1093/ntr/ntp123
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发表时间：
2009-10-01
影响因子：
4.7
通讯作者：
McFall, Miles
中科院分区：
文献类型：
--
作者：
Cook, Jessica;Jakupcak, Matthew;McFall, Miles
尽管吸烟与创伤后应激障碍(PTSD)之间有很强的联系，但影响这一人群吸烟的机制仍不清楚。以前的吸烟研究主要将创伤后应激障碍视为一种同质综合征，尽管创伤后应激障碍由四个不同的症状群组成(即重复体验、努力回避、情绪麻木和高度唤醒)。检查吸烟和创伤后应激障碍症状群之间的关系可能会增加对吸烟和创伤后应激障碍共病的影响机制的理解。本研究的目标是(A)检查总体创伤后应激障碍症状严重程度对吸烟和吸烟加重的可能性的影响，以及(B)检查每个创伤后应激障碍症状群对吸烟的影响。参与者(N=439)是伊拉克自由行动/持久自由行动退伍军人转介到退伍军人精神卫生服务。多项Logistic回归被选择纳入三个水平的结果，其中不吸烟者的可能性被比较(A)轻度吸烟(1-9支/天)，(B)中度吸烟(10-19支/天)，和(C)重度吸烟(>；=20支/天)。结果显示，总体创伤后应激障碍症状水平较高的退伍军人更有可能支持大量吸烟(Wald=4.56，p=.03，优势比[OR]=1.65)。支持情绪麻木程度高的退伍军人也更有可能支持大量吸烟(Wald=6.49，p=.01，OR=1.81)；所有其他PTSD症状群与吸烟无关。情绪麻木与日常大量吸烟之间的关联表明，患有创伤后应激障碍的退伍军人可能会吸烟以克服创伤暴露后的情绪迟钝。
Despite the strong association between smoking and posttraumatic stress disorder (PTSD), mechanisms influencing smoking in this population remain unclear. Previous smoking research has largely examined PTSD as a homogenous syndrome despite the fact that PTSD is composed of four distinct symptom clusters (i.e., reexperiencing, effortful avoidance, emotional numbing, and hyperarousal). Examination of the relationship between smoking and PTSD symptom clusters may increase understanding of mechanisms influencing comorbidity between smoking and PTSD. The goals of the present study were to (a) examine the influence of overall PTSD symptom severity on likelihood of smoking and smoking heaviness and (b) examine the influence of each PTSD symptom cluster on smoking.Participants (N = 439) were Operation Iraqi Freedom/Operation Enduring Freedom combat veterans referred to VA mental health services.Multinomial logistic regression was chosen to accommodate a three-level outcome, in which the likelihood of being a nonsmoker was compared with (a) light smoking (1-9 cigarettes/day), (b) moderate smoking (10-19 cigarettes/day), and (c) heavy smoking (>= 20 cigarettes/day). Results showed that veterans with higher levels of overall PTSD symptomatology were more likely to endorse heavy smoking (Wald = 4.56, p = .03, odds ratio [OR] = 1.65). Veterans endorsing high levels of emotional numbing were also more likely to endorse heavy smoking (Wald = 6.49, p = .01, OR = 1.81); all other PTSD symptom clusters were unrelated to smoking.The association between emotional numbing and heavy daily smoking suggests that veterans with PTSD may smoke to overcome emotional blunting following trauma exposure.