A prospective study of posttraumatic stress symptom development and cannabis use among trauma exposed injured emerging adults following Emergency Department discharge

项目总结 经历创伤性身体损伤的个人面临一系列负面后果的高风险 例如创伤后应激障碍(PTSD)和药物滥用。创伤后早期(即 暴露后的几天、几周和几个月)代表着关键的恢复期，可能特别 对于了解新兴成年人(18-25岁)的症状发展很重要 以药物使用行为的发展高峰和创伤暴露风险增加为特征的 和受伤。随着关于大麻使用(CU)的地区性法律、文化和信仰继续发生变化，人们对此感到担忧 这种创伤可能会导致大麻使用的升级，许多人报告说，使用大麻是为了 缓解痛苦、过度觉醒和其他创伤后症状。此外，虽然美国大多数州 已将大麻用于医疗用途合法化的包括压力和创伤(如创伤后应激障碍)的后果 获得国家颁发的医用大麻许可证的资格条件，人们对CU可能会如何影响 创伤后早期病程，包括创伤后应激障碍的发展和其他与压力有关的结果，如 抑郁、焦虑和滥用药物。尽管已知内源性大麻素系统在 调节应激反应，关于安全性和有效性，存在有限(和矛盾的)证据 大麻排除了关于其在创伤后急性康复中的作用的强有力的结论，一些 前瞻性研究表明，CU对创伤后应激障碍症状有不利影响或没有长期影响。这个 拟议研究的总体目标是将慢性尿崩症定性为与创伤后症状和 一名受伤人员在创伤暴露后立即滥用大麻 新兴的成年人。我们将招募N=100名创伤暴露的大麻使用者(年龄18-25岁)，向 急诊科，用于急性伤害(例如身体攻击、严重车祸)后的评估。 出院后，参与者将完成为期4周的生态瞬时评估(EMA)，以记录CU 行为和创伤后应激障碍症状的发展，伴随着生理输出(心率)的被动收集 通过可穿戴生物传感器(智能手表)监测生理。学员将返回完成临床课程 出院后4周和6个月的问诊和症状自评。这次会议的主要目标是 研究的目的是：(A)描述创伤后应激障碍症状的发展、生理和大麻使用的过程 和(B)评估创伤后急性反应对长期的影响 6个月时出现创伤后应激障碍和其他应激敏感结果(抑郁、焦虑、滥用大麻) 后续行动。

PROJECT SUMMARY Individuals who experience traumatic physical injury are at a heightened risk for a range of negative outcomes such as posttraumatic stress disorder (PTSD) and substance misuse. The early post-trauma period (i.e., the days, weeks, and months following exposure) represents a critical period of recovery and may be especially important for understanding symptom development among emerging adults (aged 18-25), who are characterized by a developmental peak in substance use behaviors and an increased risk for trauma exposure and injury. As regional laws, cultures, and beliefs about cannabis use (CU) continue to shift, there is concern that traumatic injury may result in escalations in cannabis use, as many individuals report using cannabis to relieve distress, hyperarousal, and other post-trauma symptoms. Furthermore, while the majority of US states that have legalized cannabis for medical use include outcomes of stress and trauma (such as PTSD) as qualifying conditions for a state-issued medical marijuana license, little is known about how CU may impact the early post-trauma course, including development of PTSD and other stress-related outcomes such as depression, anxiety, and substance misuse. Despite the known role of the endocannabinoid system in regulating the stress response, limited (and contradicting) evidence exists regarding safety and efficacy of cannabis precludes strong conclusions about its role during acute post-trauma recovery, with some prospective studies demonstrating detrimental or no long-term effects of CU on PTSD symptoms. The overarching goals of the proposed study are to characterize CU as related to post-trauma symptoms and cannabis misuse during the period immediately following trauma exposure among a sample of injured emerging adults. We will recruit N=100 trauma-exposed cannabis users (aged 18-25) presenting to the Emergency Department for evaluation after acute injury (e.g., physical assault, serious vehicular crashes). Upon discharge, participants will complete 4-weeks of ecological momentary assessment (EMA) to record CU behavior and PTSD symptom development, paired with passive collection of physiological output (heart rate) via wearable biosensors (smartwatch) to monitor physiology. Participants will return for completion of clinical interview and self-report of symptoms at 4-weeks and 6-months post-discharge. The main objectives of this research are to: (a) characterize the course of PTSD symptom development, physiology, and cannabis use during the acute post-trauma period and (b) evaluate effects of the acute post-trauma response on long term development of PTSD and other stress sensitive outcomes (depression, anxiety, cannabis misuse) at 6-month follow-up.