Trauma-Related Drinking to Cope: A Novel Approach to the Self-Medication Model
Trauma-Related Drinking to Cope: A Novel Approach to the Self-Medication Model
复制标题
DOI：
10.1037/adb0000552
复制
发表时间：
2020-05-01
影响因子：
3.4
通讯作者：
Amstadter, Ananda B.
中科院分区：
文献类型：
--
作者：
Hawn, Sage E.;Bountress, Kaitlin E.;Amstadter, Ananda B.
人们提出了多种病因学模型来解释创伤后应激障碍（PTSD）和酒精使用障碍（AUD）的共病，但迄今为止最主要的模型是“饮酒科普”自我药疗模型。尽管它的流行，自我药疗模式缺乏严格的经验支持相关的不一致性和方法的局限性，特别是未能操作化饮酒，以科普创伤症状具体。本研究旨在测量创伤相关的饮酒以科普（TRD），以提供一个更具体的测试自我药疗模型之间的代表性样本的1,896名大学生的创伤暴露和酒精使用的历史。使用Mplus中的模型构建方法，相关多介质模型通过TRD和更广义的饮酒以应对动机（通过饮酒动机问卷的应对子量表评估; DMQ-科普）测试PTSD症状与酒精使用问题（AUPs）之间的关联，并由性别调节。结果表明，虽然占广义饮酒，以科普动机的影响，TRD部分介导的PTSD症状和AUPs之间的关系，这种关系是男性比女性更强。除了按性别的适度外，结果得到了纵向数据的证实。研究结果与自我药疗模型一致，表明TRD动机可能是PTSD症状影响AUPs的一种机制。与常用的DMQ-Cope相比，TRD可以作为一种更具体的筛查工具，用于支持PTSD症状的个体中的AUP风险。
Multiple etiological models have been proposed to explain posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) comorbidity, but the predominant model to date is the "drinking to cope" self-medication model. Despite its popularity, the self-medication model lacks rigorous empirical support related to inconsistencies and methodological limitations, particularly the failure to operationalize drinking to cope with trauma symptoms specifically. The present study sought to measure trauma-related drinking to cope (TRD) in order to provide a more specific test of the self-medication model among a representative sample of 1,896 undergraduates with a history of trauma exposure and alcohol use. Using a model-building approach in Mplus, a correlated multiple mediator model tested the association between PTSD symptoms and alcohol use problems (AUPs) through TRD and more generalized drinking to cope motives (as assessed by the coping subscale of the Drinking Motives Questionnaire; DMQ-Cope) as moderated by sex. Results indicated that, while accounting for the effects of generalized drinking to cope motives, TRD partially mediated the relation between PTSD symptoms and AUPs and that this relationship was stronger for males than for females. With the exception of moderation by sex, results were substantiated using longitudinal data. Findings were consistent with the self-medication model, suggesting that TRD motives may serve as a mechanism through which PTSD symptoms influence AUPs. TRD may serve as a more specific screening tool for AUP risk among individuals endorsing PTSD symptoms compared with the commonly used DMQ-Cope.