The prevalence of co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) remains exceptionally high among returning veterans, with numerous studies linking PTSD, but not specific PTSD symptoms, to future SUD risk. Further explication of PTSD symptom effects on future SUD risk will likely promote intervention development and refinement while offsetting SUD risk. Accordingly, In this study we explored the prospective associations between PTSD symptom clusters, symptoms, and future SUD risk and use of specific drug classes. Returning veterans (N = 1,295; Mage = 42.3, SD = 9.89; 51% female; 66.8% White) completed structured diagnostic interviews to assess PTSD symptoms and self-report measures of substance use 14-36 months later (M = 24.59, SD = 2.97). Hyperarousal and reckless/self-destructive symptoms specifically predicted future high-risk drug use and binge drinking behavior, and avoidance of internal stimuli (i.e., of trauma memories, thoughts, and feelings) differentiated individuals classified as high-risk for alcohol use based on their AUDIT total score. Further, negative alterations in cognition and mood predicted future opioid (i.e., nightmares) and stimulant use (i.e., flashbacks), whereas concentration difficulties were inversely associated with future binge drinking. This longitudinal study identified prospective and enduring associations between specific PTSD symptom clusters, symptoms, and future high-risk substance use patterns among returning veterans. Accordingly, careful assessment of specific PTSD criteria and differential motivations for substance use is warranted, along with tailored interventions to offset risk for opioid, stimulant, and alcohol use among returning veterans. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

中文翻译：

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PTSD症状群和标准在预测回国老兵中未来高风险药物和酒精使用中的作用。

回返的退伍军人中并发的创伤后应激障碍（PTSD）和物质使用障碍（SUD）的患病率仍然异常高，许多研究将PTSD（但不是特定的PTSD症状）与将来的SUD风险联系起来。PTSD症状对未来SUD风险的进一步影响可能会促进干预措施的发展和完善，同时抵消SUD风险。因此，在这项研究中，我们探索了PTSD症状群，症状与未来SUD风险和特定药物类别的使用之间的前瞻性关联。返回的退伍军人（N = 1,295；法师= 42.3，SD = 9.89；女性51％； 66.8％白人）完成了结构化诊断访谈，以评估PTSD症状和14-36个月后物质使用的自我报告措施（M = 24.59，SD = 2.97）。过度刺激和鲁re /自我毁灭的症状特别预测了未来的高风险药物使用和暴饮暴食行为，以及避免内部刺激（即，创伤记忆，思想和感觉）的不同，将基于酒精滥用而被归类为高风险的个体他们的AUDIT总分。此外，认知和情绪的负面变化预示着未来的阿片类药物（即噩梦）和兴奋剂的使用（即闪回），而集中注意力的困难与将来的暴饮暴食成反比。这项纵向研究确定了特定的PTSD症状群，症状与返回的退伍军人之间未来的高风险物质使用模式之间的前瞻性和持久性关联。因此，必须仔细评估具体的PTSD标准和物质使用的不同动机，以及量身定制的干预措施，以抵消回返老兵中阿片类药物，兴奋剂和酒精使用的风险。（PsycInfo数据库记录（c）2021 APA，保留所有权利）。