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) 2022 APA, all rights reserved).

中文翻译：

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PTSD 症状群和标准在预测退伍军人男性和女性未来高风险药物和酒精使用中的作用。

同时发生的创伤后应激障碍 (PTSD) 和物质使用障碍 (SUD) 的患病率在返回的退伍军人中仍然非常高，许多研究将 PTSD 而非特定的 PTSD 症状与未来的 SUD 风险联系起来。进一步解释 PTSD 症状对未来 SUD 风险的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，我们探讨了 PTSD 症状群、症状和未来 SUD 风险与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；Mage = 42.3，SD = 9.89；51% 女性；66.8% 白人）在 14-36 个月后完成了结构化诊断访谈以评估 PTSD 症状和物质使用的自我报告措施（M = 24.59，SD = 2.97）。过度兴奋和鲁莽/自毁症状特别预测了未来的高风险吸毒和酗酒行为，并且回避内部刺激（即创伤记忆、思想和感受）区分了基于以下因素被归类为高风险饮酒的个体他们的审计总分。此外，认知和情绪的负面改变预示着未来的阿片类药物（即噩梦）和兴奋剂的使用（即闪回），而注意力不集中与未来的酗酒成反比。这项纵向研究确定了返回退伍军人中特定 PTSD 症状群、症状和未来高风险物质使用模式之间的前瞻性和持久关联。因此，有必要仔细评估特定的 PTSD 标准和物质使用的不同动机，以及量身定制的干预措施，以抵消返回退伍军人使用阿片类药物、兴奋剂和酒精的风险。（PsycInfo 数据库记录 (c) 2022 APA，保留所有权利）。