Stress-induced Drinking in OEF/OIF Veterans: The Role of Combat History and PTSD

描述(申请人提供)：暴露在与战斗有关的创伤事件中的军事人员，特别是那些患有创伤后应激障碍(PTSD)的军事人员，有更高的问题饮酒发生率。然而，关于创伤、创伤后应激障碍和“新兴成年人”(21-30岁)饮酒之间的关系，人们知之甚少，尽管这一年龄段的人随后出现饮酒问题的风险最高。拟议的临床实验室项目将采用三组设计。目标OIF/OEF人群将没有创伤暴露[对照组]，没有创伤后应激障碍的战斗创伤暴露[TE组]，以及有创伤后应激障碍的战斗创伤暴露[PTSD组]。创伤事件暴露史包括的类型将限于与战斗有关的创伤事件，这些事件本质上是人际关系的。这个项目将使用我们小组使用的成熟的应激诱导临床实验室范例，Trier社会应激测试(TSST)，以调查战斗创伤暴露史对TSST的反应性和应激诱导的自愿饮酒的作用。受试者将不符合酒精依赖的诊断标准。每组的一半将接受TSST，另一半将被随机分配到无应激条件。第一个具体目标是使用主观和生物学的应激指数，通过主观、神经内分泌和生理应激的测量，检验战斗创伤史对应激反应的影响。第二个具体目标将使用临床实验室范例中的既定程序来研究战斗创伤史对随后的饮酒行为和对酒精的主观反应的影响。探索性分析还将检验战斗创伤史组与主观应激反应的相关性，以及战斗创伤史组与饮酒的相关性。另外两个探索性分析将评估痛苦耐受性(高和低)的人格特征的影响，以及携带5-HTTLPR多态的‘S’或罕见的‘LG’等位基因对应激反应和应激诱导后自愿饮酒的影响。这项研究将促进我们对战斗相关创伤事件史、压力和饮酒之间的关系的理解。这一系列研究的最终目标是在不健康的饮酒行为和/或依赖形成之前，在饮酒生涯的早期识别“高危”群体。这些信息有可能为预防和干预酒精研究提供信息。

DESCRIPTION (provided by applicant): Military personnel exposed to combat-related traumatic events, particularly those who develop posttraumatic stress disorder (PTSD), have a higher incidence of problematic drinking. However, little is known about the relationship between trauma, PTSD, and drinking in "emerging adults" (ages 21-30 years), in spite of this age group being at highest risk of developing subsequent drinking problems. The proposed clinical laboratory project will use a three group design. The target OIF/OEF population will have no trauma exposure [Control group], combat trauma exposure without PTSD [TE group], and combat trauma exposure with PTSD [PTSD group]. The type of traumatic event exposure history included will be limited to combat- related traumatic events that are interpersonal in nature. This project will use a well-established clinical laboratory paradigm of stress induction employed by our group, the Trier Social Stress Test (TSST), to investigate the role of a history of exposure to combat trauma on reactivity to the TSST and on stress- induced voluntary drinking. Subjects will not meet diagnostic criteria for alcohol dependence. Half of each group will receive the TSST and the other half will be randomized to the no stress condition. Using subjective as well as biological indices of stress, the first specific aim examines the effect of combat trauma history on stress reactivity, using subjective, neuroendocrine, and physiological measures of stress. The second specific aim will examine the effect of combat trauma history on subsequent drinking behavior and subjective response to alcohol using established procedures in a clinical laboratory paradigm. Exploratory analyses will also be conducted to examine the correlation between combat trauma history group and subjective response to stress, and combat trauma history group and drinking. Two additional exploratory analyses will evaluate the effect of the personality trait of distress tolerance (high and low), and the effect of carrying the 'S' or the rare 'LG' allele of the 5-HTTLPR polymorphism on the stress response and on voluntary drinking following stress induction. This study will advance our understanding of the relationship between a history of combat-related traumatic events, stress, and drinking. The ultimate goal of this line of research is to identify "at risk" groups early in their drinking careers, before unhealthy drinking practices and/or dependence develop. This information has the potential to inform prevention and intervention alcohol research.