Trauma exposure predicts alcohol, nicotine, and drug problems beyond the contribution of PTSD and depression in patients with cardiovascular disease: data from the Heart and Soul Study.
Trauma exposure predicts alcohol, nicotine, and drug problems beyond the contribution of PTSD and depression in patients with cardiovascular disease: data from the Heart and Soul Study.
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创伤暴露可以预测心血管疾病患者的酒精、尼古丁和毒品问题，而不仅仅是创伤后应激障碍和抑郁症：来自心与灵魂研究的数据。
DOI：
10.1111/j.1521-0391.2013.12053.x
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Cohen,BethE
中科院分区：
文献类型：
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作者：
Waldrop,AngelaE;Cohen,BethE
背景和目的本研究在一项成人心血管疾病患者的纵向研究中考察了终生创伤暴露的作用，以确定创伤暴露对药物、酒精问题和吸烟风险的独特贡献。方法数据来自心脏与灵魂研究，这是一项前瞻性队列研究，旨在确定高危患者心理因素与心血管事件风险增加之间的关联机制（n= 1022）。结果终生接触较多创伤类型对物质使用结果的预测超出了PTSD和抑郁症所解释的风险。此外，在创伤类型中，人际创伤与物质使用问题的关系最为密切。结论创伤暴露与药物使用之间的关系，除了PTSD和抑郁症起作用外，其他因素也起作用；因此，只关注这些心理合并症是不够的。将精神卫生保健和/或病例管理支持与初级和专科医疗保健相结合，可以改善对物质使用和共病精神和身体健康问题患者的发现和治疗。创伤暴露筛查是良好临床护理的重要组成部分。（Am J Addict 2014; 23:53-61）
Background and ObjectivesThis study examined the role of lifetime trauma exposure in a longitudinal study of adults with cardiovascular disease to determine the unique contribution of trauma exposure to risk for drug and alcohol problems and smoking.MethodsData were drawn from the Heart and Soul Study, a prospective cohort study designed to determine the mechanisms of associations between psychological factors and increased risk of cardiovascular events in high‐risk patients (n= 1,022).ResultsLifetime exposure to a higher number of trauma types predicted substance use outcomes beyond risk explained by PTSD and depression. In addition, across trauma types, interpersonal traumas were most strongly associated with substance use problems.ConclusionsOur results suggest that, though PTSD and depression play a role in the association between trauma exposure and substance use, many other factors also contribute; therefore focusing on these psychological comorbidities alone is not sufficient.Scientific SignificanceThe integration of mental health care and/or case management support with primary and specialty medical care may improve detection and treatment for patients with substance use and comorbid mental and physical health problems. Screening for trauma exposure is an important part of good clinical care. (Am J Addict 2014;23:53–61)