The impact of treatment condition and the lagged effects of PTSD symptom severity and alcohol use on changes in alcohol craving
The impact of treatment condition and the lagged effects of PTSD symptom severity and alcohol use on changes in alcohol craving
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DOI：
10.1016/j.brat.2016.02.001
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发表时间：
2016-04-01
影响因子：
4.1
通讯作者：
Foa, Edna B.
中科院分区：
文献类型：
--
作者：
Kaczkurkin, Antonia N.;Asnaani, Anu;Foa, Edna B.
鉴于创伤后应激障碍（PTSD）和物质使用障碍（SUD）之间的共病率很高，我们研究了这些疾病的综合治疗。患有PTSD和酒精依赖共病的个体随机接受纳洛酮或安慰剂，有或没有长期暴露（PE）。所有参与者都接受了BRENDA（支持性咨询）。纳洛酮加PE组的酒精渴求症状下降幅度大于安慰剂无PE组。在酒精渴求方面，PE加安慰剂组和无PE的纳洛酮组与无PE的安慰剂组没有显著差异。未发现饮酒天数百分比的治疗组差异。酒精渴望受PTSD严重程度的影响，PTSD症状越严重，酒精渴望下降越快。创伤后应激障碍和饮酒对酒精渴望都有滞后效应，创伤后应激障碍症状的变化和饮酒天数的百分比与随后的渴望变化相关。这些结果支持更大的PTSD症状导致更大的酒精渴望之间的关系，并表明减少PTSD症状可能有利于减少那些合并PTSD/SUD的渴望。(C)2016爱思唯尔有限公司版权所有。
Given the high rates of comorbidity between posttraumatic stress disorder (PTSD) and substance use disorder (SUD), we investigated an integrated treatment for these disorders. Individuals with comorbid PTSD and alcohol dependence were randomized to receive naltrexone or placebo, with or without prolonged exposure (PE). All participants also received BRENDA (supportive counseling). The naltrexone plus PE group showed a greater decline in alcohol craving symptoms than those in the placebo with no PE group. The PE plus placebo and the naltrexone without PE groups did not differ significantly from the placebo with no PE group in terms of alcohol craving. No treatment group differences were found for percentage of drinking days. Alcohol craving was moderated by PTSD severity, with those with higher PTSD symptoms showing faster decreases in alcohol craving. Both PTSD and alcohol use had a lagged effect on alcohol craving, with changes in PTSD symptoms and percentage of days drinking being associated with subsequent changes in craving. These results support the relationship between greater PTSD symptoms leading to greater alcohol craving and suggest that reducing PTSD symptoms may be beneficial to reducing craving in those with co-occurring PTSD/SUD. (C) 2016 Elsevier Ltd. All rights reserved.