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PTSD Symptom Clusters and Craving Differs by Primary Drug of Choice
Journal of Dual Diagnosis ( IF 1.5 ) Pub Date : 2019-07-14 , DOI: 10.1080/15504263.2019.1637039
Vanessa C Somohano 1 , Kristoffer L Rehder 1 , Tyree Dingle 1 , Taylor Shank 1 , Sarah Bowen 1
Affiliation  

Abstract Objective: Research has demonstrated a cyclical relationship between posttraumatic stress disorder (PTSD) and substance use disorder. Identifying factors that link PTSD symptom clusters and substance use disorder may illuminate mechanisms underlying the PTSD–substance use disorder relationship, better informing interventions that target this comorbidity. The current study of individuals enrolled in an outpatient aftercare chemical dependency program in King County, Washington, assessed whether overall PTSD symptoms and specific PTSD symptom clusters predicted craving depending on individuals identified primary drug of choice (DOC). Methods: Participants eligible for the parent study were at least 18 years of age, fluent in English, medically cleared from substance withdrawal, and able to participate in treatment sessions and agreed to random assignment. Random assignment to either a mindfulness-based relapse prevention group, a standard relapse prevention group, or a treatment as usual group was conducted on a computer randomization program. A secondary analysis of baseline data was employed in the current study to determine which of the PTSD symptom clusters (avoidance, hyperarousal, and intrusion) predicted substance craving. Results: Covarying for severity of dependence, results suggest that overall PTSD scores predicted craving in participants who identified alcohol, stimulants, and opiates as their primary DOC. Further, avoidance-related PTSD symptoms alone predicted a significant proportion of the variability in craving in stimulant users, and hyperarousal symptoms alone predicted a significant proportion of the variability in craving in alcohol users. No specific PTSD cluster significantly predicted a proportion of the variability in craving in marijuana or opiates users. Conclusions: Findings suggest that craving may play a role in maintaining the relationship between specific PTSD symptom clusters and substance use disorder, and the nature of this relationship may differ by primary DOC. The clinical trial on which this secondary analysis of data was conducted is registered as NCT01159535 at www.clinicaltrials.gov. The original trial from which data for this study was drawn was supported by the National Institutes of Health [NIH/NIDA 5 R01 DA025764-02].

中文翻译:

PTSD 症状群和渴望因首选药物而异

摘要 目的:研究表明,创伤后应激障碍(PTSD)与物质使用障碍之间存在周期性关系。确定将 PTSD 症状群和物质使用障碍联系起来的因素可能会阐明 PTSD 与物质使用障碍关系的潜在机制,更好地为针对这种共病的干预措施提供信息。目前在华盛顿金县参加门诊后护理化学依赖计划的个人的当前研究评估了整体 PTSD 症状和特定的 PTSD 症状群是否预测了依赖于个人确定的首选药物 (DOC) 的渴望。方法:符合父母研究条件的参与者至少年满 18 岁,英语流利,医学上没有戒断药物,并且能够参加治疗并同意随机分配。随机分配到基于正念的复发预防组、标准复发预防组或常规治疗组是根据计算机随机程序进行的。本研究采用了对基线数据的二次分析,以确定哪些 PTSD 症状群(回避、过度觉醒和侵入)预测了对物质的渴望。结果:随着依赖严重程度的变化,结果表明总体 PTSD 分数预测了将酒精、兴奋剂和阿片类药物确定为主要 DOC 的参与者的渴望。此外,仅与回避相关的 PTSD 症状就预测了兴奋剂使用者渴望的很大一部分变异性,和过度觉醒的症状本身就预测了酒精使用者渴望变化的很大一部分。没有特定的 PTSD 集群显着预测大麻或阿片类药物使用者渴望的变异性比例。结论:研究结果表明,渴望可能在维持特定 PTSD 症状群与物质使用障碍之间的关系中发挥作用,这种关系的性质可能因主要 DOC 而异。对数据进行二次分析的临床试验在 www.clinicaltrials.gov 上注册为 NCT01159535。为这项研究提取数据的原始试验得到了美国国立卫生研究院的支持 [NIH/NIDA 5 R01 DA025764-02]。没有特定的 PTSD 集群显着预测大麻或阿片类药物使用者渴望的变异性比例。结论:研究结果表明,渴望可能在维持特定 PTSD 症状群与物质使用障碍之间的关系中发挥作用,这种关系的性质可能因主要 DOC 而异。对数据进行二次分析的临床试验在 www.clinicaltrials.gov 上注册为 NCT01159535。为这项研究提取数据的原始试验得到了美国国立卫生研究院的支持 [NIH/NIDA 5 R01 DA025764-02]。没有特定的 PTSD 集群显着预测大麻或阿片类药物使用者渴望的变异性比例。结论:研究结果表明,渴望可能在维持特定 PTSD 症状群与物质使用障碍之间的关系中发挥作用,这种关系的性质可能因主要 DOC 而异。对数据进行二次分析的临床试验在 www.clinicaltrials.gov 上注册为 NCT01159535。为这项研究提取数据的原始试验得到了美国国立卫生研究院的支持 [NIH/NIDA 5 R01 DA025764-02]。这种关系的性质可能因主要 DOC 而异。对数据进行二次分析的临床试验在 www.clinicaltrials.gov 上注册为 NCT01159535。为这项研究提取数据的原始试验得到了美国国立卫生研究院的支持 [NIH/NIDA 5 R01 DA025764-02]。这种关系的性质可能因主要 DOC 而异。对数据进行二次分析的临床试验在 www.clinicaltrials.gov 上注册为 NCT01159535。为这项研究提取数据的原始试验得到了美国国立卫生研究院的支持 [NIH/NIDA 5 R01 DA025764-02]。
更新日期:2019-07-14
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