An Examination of the Effects of PTSD Symptom Severity and Global Sleep Disturbance on Alcohol Cue Reactivity

项目总结/摘要 酒精使用障碍（AUD）和创伤后应激障碍（PTSD）是复杂的精神疾病， 通常是同时发生的。AUD/PTSD合并症的特点是更昂贵、严重和慢性的临床症状。 当然，与单独的任何一种疾病相比。目前AUD/PTSD的治疗方法是 其特征在于小的效应大小和显著的磨损。一个重要的途径， 包括将我们的科学注意力集中在跨诊断，可塑性机制， 显著影响AUD/PTSD共病。整体睡眠紊乱代表了一种潜在的 贡献者。具体来说，整体睡眠障碍，特别是那些有创伤后应激障碍症状的人， 通过增加对负面情绪的反应性来维持AUD，这可能因此 增加对酒精的渴望。在此背景下，本申请案的目标为： 确定PTSD症状严重程度与酒精渴望的相关程度， （B）检查作为调节剂的整体睡眠障碍， PTSD症状严重程度与酒精渴求之间的关系， 酒精和创伤暗示该项目的中心假设是，整体睡眠障碍缓和，或 加剧了PTSD症状严重程度和酒精渴望之间的关系， 对酒精和创伤线索的反应方法是招募60个个体进行线索反应实验 该范例将测试PTSD症状严重程度和整体睡眠障碍对酒精渴望的影响 通过对酒精和创伤线索的情绪反应来衡量。研究候选人将符合当前标准 (past月）DSM-5 AUD，根据DSM-5 PTSD标准A报告创伤暴露史， (past月）亚临床（每簇一种症状）或诊断DSM-5 PTSD（N = 60）。完成时 在这个项目中，人们期望创伤后应激障碍症状的严重程度和整体睡眠障碍对 将进一步阐明醇提示反应性。这项研究的影响是提高了对 与AUD/PTSD相关的机制，这是一种具有显著健康负担的复杂共病。拟议 该项目与国家酒精滥用和酒精中毒研究所的使命声明相协调 （NIAAA），其重点是酒精消费的健康风险，预防和治疗，以及其 强调增加对与饮酒有关的正常和异常行为的了解。最后， 雅阁国家航空航天局的战略规划目标，研究成果将被翻译和传播 卫生保健提供者、研究人员、政策制定者和公众。总而言之，该奖项将支持大量 培训研究方法，统计分析和传播给有前途的年轻研究人员，并将 解决了对PTSD症状严重程度影响的实验研究的重大需求， 总体睡眠障碍对AUD/PTSD患者酒精线索反应性的影响

PROJECT SUMMARY/ABSTRACT Alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) are complex psychiatric conditions that commonly co-occur. The AUD/PTSD comorbidity is marked by a more costly, severe, and chronic clinical course, when compared to either disorder alone. Current treatment approaches for AUD/PTSD are characterized by small effect sizes and significant attrition. A key avenue for informing our understanding of AUD/PTSD includes focusing our scientific attention to transdiagnostic, malleable mechanisms that significantly impact the AUD/PTSD comorbidity. Global sleep disturbance represents one potential contributor. Specifically, global sleep disturbance, particularly among those with PTSD symptoms, may contribute to the maintenance of the AUD by increasing reactivity to negative emotionality, which may thus increase alcohol craving. Against this background, the objectives of the current application are to: (a) determine the extent to which PTSD symptom severity is associated with alcohol craving as measured by emotional reactivity to alcohol and trauma cues and (b) examine global sleep disturbance as a moderator of the relationship between PTSD symptom severity and alcohol craving as measured by emotional reactivity to alcohol and trauma cues. The central hypothesis of this project is that global sleep disturbance moderates, or exacerbates, the relationship between PTSD symptom severity and alcohol craving as measured by emotional reactivity to alcohol and trauma cues. The approach is to recruit 60 individuals for a cue-reactivity experimental paradigm that will test the effects of PTSD symptom severity and global sleep disturbance on alcohol craving as measured by emotional reactivity to alcohol and trauma cues. Study candidates will meet criteria for current (past month) DSM-5 AUD, reporting a history of trauma exposure per DSM-5 PTSD Criterion A, and current (past month) subclinical (one symptom per cluster) or diagnostic DSM-5 PTSD (N = 60). At the completion of this project, it is the expectation that the effects of PTSD symptom severity and global sleep disturbance on alcohol cue reactivity will be further elucidated. The impact of this study is improved understanding of mechanisms related to AUD/PTSD, a complex comorbidity with significant health burden. The proposed project coordinates with the mission statement of the National Institute of Alcohol Abuse and Alcoholism (NIAAA) with its emphasis on the health risks of alcohol consumption, prevention, and treatment, and with its emphasis on increasing the understanding of normal and abnormal behavior relating to alcohol use. Ultimately, in accord with the strategic planning goals of NIAAA, the research findings will be translated and disseminated to health care providers, researchers, policymakers, and the public. In sum, this award will support substantial training in research methods, statistical analysis, and dissemination to a promising young researcher and will address a significant need for an experimental investigation of the effects of PTSD symptom severity and global sleep disturbance on alcohol cue reactivity among those suffering from AUD/PTSD.