Emotional engagement and relapse to alcohol use in a trauma-exposed sample

创伤暴露样本中的情绪投入和酗酒复发

• 批准号: 8130544
• 负责人: MICHELE A BEDARD-Gilligan
• 金额: $ 5.36万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-16 至 2012-09-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8130544
• 关键词: Address; Affect; Aftercare; Alcohol consumption; Alcohol dependence; Alcohols; Belief; Clinical; Code; Cognition; Comorbidity; Distress; Emotional; Emotions; Enrollment; Evaluation; Event; Exhibits; Goals; Individual; Intervention; Linguistics; Measures; Mediating; Memory; Modeling; Nature; Patient Self-Report; Persons; Population; Post-Traumatic Stress Disorders; Recording of previous events; Refractory; Relapse; Reporting; Research; Resistance; Resolution; Sampling; Symptoms; Testing; Time; Trauma; Woman; Writing; alcohol abuse therapy; alcohol craving; alcohol relapse; alcohol response; alcohol use disorder; coping; coping mechanism; craving; design; drinking; drinking behavior; emotional experience; experience; follow-up; improved; indexing; theories; treatment program; use alcohol to cope

DESCRIPTION (provided by applicant): Posttraumatic stress disorder (PTSD) and alcohol use disorders (AUD) co-occur frequently which is a concern given that individuals with PTSD and AUD are more treatment resistant and prone to substance relapse following treatment compared to individuals with only AUD. This relationship may be explained by theories positing that individuals with PTSD and AUD use alcohol to cope with distressing PTSD symptoms. Theories of PTSD suggest that emotional engagement, or evoking key emotional experiences related to the trauma memory, is crucial in resolving PTSD symptoms. However, trauma-related symptoms and emotions are often not addressed in treatment for AUD. Thus, lack of emotional engagement may contribute to alcohol relapse through a cycle where unresolved PTSD symptoms maintain alcohol cravings and use. Given the treatment refractory nature of AUDs when comorbid with PTSD, understanding underlying mechanisms explaining how symptoms of PTSD may contribute to alcohol relapse and how we may best intervene with this population is of great clinical importance. The overall goal of this study is to examine emotional engagement with the trauma memory during treatment for AUD as a predictor of decreased relapse to alcohol use following treatment. More specifically, the proposed research will investigate the direct relationship between emotional engagement with the trauma memory and self-reported alcohol cravings and relapse at 3-months post-treatment for AUD, the relationship between beliefs about ability to tolerate trauma-related emotions, coping motives for alcohol use and self-reported alcohol cravings and relapse at 3-months post-treatment for AUD, and whether these coping beliefs mediate the relationship between emotional engagement, alcohol cravings, and relapse to alcohol use. This study will enroll 100 women currently in treatment for alcohol dependence with co-occurring trauma histories and symptoms of PTSD. Assessments will be conducted at pre-treatment, post-treatment, and at 3-month follow-up time points. In order to explore study aims, emotional engagement will be manipulated through a three session narrative writing assignment designed to elicit emotional engagement with the memory and level of emotional engagement will be assessed with both self-report and coding measures. In addition, beliefs about ability to tolerate trauma-related distress and coping motives for alcohol use as well as cravings and relapse will be examined. Overall, this study seeks to better understand mechanisms of relapse to alcohol use in women with PTSD and AUD, and has the potential to identify important intervention targets for this difficult to treat population.

描述（由申请人提供）：创伤后应激障碍（PTSD）和酒精使用障碍（AUD）经常共同发生，这是一个问题，因为与仅患有AUD的个体相比，患有PTSD和AUD的个体更具治疗抗性，并且在治疗后更容易复发。这种关系可以通过假设PTSD和AUD患者使用酒精来科普痛苦的PTSD症状的理论来解释。创伤后应激障碍的理论表明，情感参与，或唤起与创伤记忆相关的关键情感体验，对解决创伤后应激障碍症状至关重要。然而，创伤相关的症状和情绪通常不会在AUD的治疗中得到解决。因此，缺乏情感参与可能会导致酒精复发，通过一个循环，未解决的PTSD症状维持酒精渴望和使用。考虑到AUDs与PTSD共病时的治疗难治性，理解解释PTSD症状如何导致酒精复发的潜在机制以及我们如何最好地干预这一人群具有重要的临床意义。本研究的总体目标是检查情绪参与与创伤记忆在治疗过程中的AUD作为减少复发酒精使用治疗后的预测。更具体地说，拟议的研究将调查情绪参与与创伤记忆和自我报告的酒精渴望之间的直接关系，以及在治疗后3个月的AUD复发，关于耐受创伤相关情绪的能力的信念之间的关系，酒精使用的应对动机和自我报告的酒精渴望，以及在治疗后3个月的AUD复发，以及这些应对信念是否调节了情感投入、酒精渴望和酒精使用复发之间的关系。这项研究将招募100名目前正在接受酒精依赖治疗的女性，这些女性同时患有创伤史和创伤后应激障碍症状。将在治疗前、治疗后和3个月随访时间点进行评估。为了探索研究目的，情感参与将通过三个会话的叙事写作任务，旨在引起情感参与的记忆和情感参与的水平将与自我报告和编码措施进行评估。此外，信仰的能力，以容忍创伤相关的痛苦和应对动机，酒精使用以及渴望和复发将进行检查。总的来说，这项研究旨在更好地了解PTSD和AUD女性酒精使用复发的机制，并有可能为这一难以治疗的人群确定重要的干预目标。