Abstract Objective: Posttraumatic stress disorder (PTSD) often co-occurs with substance use (SU). Although there has been independent research on subgroups of participants based on their PTSD or SU responses, rarely are PTSD-SU typologies examined consistent with a precision medicine approach (and corresponding person-centered statistical approaches). The current study examined the nature and construct validity (covariates of depression, physical aggression, verbal aggression, anger, hostility, reckless and self-destructive behaviors [RSDB]) of the best-fitting latent class solution in categorizing participants based on PTSD (PTSD Checklist for DSM-5) and alcohol/drug use responses (Alcohol Use and Disorders Identification Test Alcohol Consumption Questions, Drug Abuse Screening Test). Methods: The sample included 375 trauma-exposed participants recruited from Amazon’s Mechanical Turk online labor market. Results: Latent class analyses indicated an optimal three-class solution (low PTSD/SU, moderate PTSD/drug and high alcohol, and high PTSD/SU). Multinomial logistic regressions indicated that depression (OR = 1.22) and frequency of RSDBs (OR = 1.20) were significant predictors of the moderate PTSD/drug and high alcohol class versus the low PTSD/SU class. Depression (OR = 1.55) and frequency of RSDBs (OR = 1.19) were significant predictors of the high PTSD/SU class versus the low PTSD/SU class. Only depression (OR = 1.27) was a significant predictor of the high PTSD/SU class versus the moderate PTSD/drug and high alcohol class. Conclusions: Results provide construct validity support for three meaningful latent classes with unique relations with depression and RSDBs. These findings improve our understanding of heterogeneous PTSD-SU comorbidity patterns and highlight acknowledgment of such subtyping (subgrouping) in considering differential treatment options, treatment effectiveness, and resource allocation.

中文翻译：

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物质使用和创伤后应激障碍同时发生的异质性：潜在类别分析方法

摘要 目的：创伤后应激障碍（PTSD）通常与物质使用（SU）同时发生。尽管已经根据参与者的 PTSD 或 SU 反应对亚组进行了独立研究，但 PTSD-SU 类型学的检查很少与精准医学方法（以及相应的以人为中心的统计方法）一致。当前的研究检验了基于 PTSD (PTSD) 对参与者进行分类的最合适潜在类解决方案的性质和结构效度（抑郁、身体攻击、言语攻击、愤怒、敌意、鲁莽和自我毁灭行为的协变量 [RSDB]）。 DSM-5 清单）和酒精/药物使用反应（酒精使用和疾病识别测试酒精消耗问题、药物滥用筛查测试）。方法：样本包括从亚马逊 Mechanical Turk 在线劳动力市场招募的 375 名遭受过创伤的参与者。结果：潜在类别分析表明了最佳的三类解决方案（低 PTSD/SU、中度 PTSD/药物和高酒精以及高 PTSD/SU）。多项 Logistic 回归表明，抑郁症 (OR = 1.22) 和 RSDB 频率 (OR = 1.20) 是中度 PTSD/药物和高酒精类与低 PTSD/SU 类的显着预测因子。抑郁 (OR = 1.55) 和 RSDB 频率 (OR = 1.19) 是高 PTSD/SU 类别与低 PTSD/SU 类别的显着预测因子。只有抑郁症（OR = 1.27）是高 PTSD/SU 类别与中度 PTSD/药物和高酒精类别的显着预测因子。结论：结果为与抑郁症和 RSDB 具有独特关系的三个有意义的潜在类别提供了结构有效性支持。这些发现提高了我们对异质性 PTSD-SU 合并症模式的理解，并强调在考虑差异化治疗方案、治疗有效性和资源分配时对此类亚型（亚组）的认识。