Abstract Objective: The co-occurrence of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) is common. Individuals with PTSD/AUD commonly drink to cope with PTSD symptoms, which maintains PTSD/AUD, and may result in increased craving for alcohol. Negative affect is implicated in negative reinforcement models of craving. Further, Emotional Processing Theory posits that posttraumatic cognitions lead to the experience of negative affect, which may result in increased craving in PTSD/AUD. The current study aims to advance the understanding of craving in PTSD/AUD by evaluating if specific posttraumatic cognitions (e.g., cognitions about the self, world, and self-blame) are associated with increased negative affect, and whether higher negative affect is associated with heightened craving. Methods: Three separate simple mediation models were utilized to test if negative affect mediated the relationship between each specific posttraumatic cognition type and craving among 136 treatment-seeking veterans with PTSD/AUD. Results: We found that negative affect mediated the association between all posttraumatic cognition types and craving. Specifically, viewing oneself as being unable to handle PTSD-related distress, viewing the world as very dangerous, and blaming oneself for one’s role in a traumatic event were all associated with increased negative affect, which was related to higher craving. Conclusions: Given that posttraumatic cognitions improve via trauma-focused treatment for PTSD, future work should evaluate whether improvements in posttraumatic cognitions via trauma-focused treatment lead to decreased negative affect and craving in PTSD/AUD.

中文翻译：

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负面影响介导了患有创伤后应激障碍和酒精使用障碍的退伍军人的创伤后认知与渴望之间的关联

摘要 目的：创伤后应激障碍（PTSD）和酒精使用障碍（AUD）同时发生是很常见的。患有 PTSD/AUD 的人通常会喝酒来应对 PTSD 症状，这会维持 PTSD/AUD，并可能导致对酒精的渴望增加。负面影响与渴望的负强化模型有关。此外，情绪加工理论认为，创伤后认知会导致负面情绪的体验，这可能会导致对 PTSD/AUD 的渴望增加。目前的研究旨在通过评估特定的创伤后认知（例如，关于自我、世界和自责的认知）是否与增加的负面情绪相关，以及较高的负面情绪是否与强烈的渴望。方法：三个独立的简单中介模型被用来测试负面情绪是否介导了 136 名患有 PTSD/AUD 的寻求治疗的退伍军人之间每种特定的创伤后认知类型和渴望之间的关系。结果：我们发现负面情绪介导了所有创伤后认知类型与渴望之间的关联。具体来说，认为自己无法处理与 PTSD 相关的痛苦，认为世界非常危险，并为自己在创伤事件中的角色自责，都与增加的负面影响有关，这与更高的渴望有关。结论：鉴于创伤后认知通过针对 PTSD 的创伤治疗得到改善，