Background

Alcohol use disorder (AUD) is prevalent among Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn (OEF/OIF/OND) veterans. Pain and posttraumatic stress disorder (PTSD) are highly comorbid and increase risk of AUD. Prior studies linking pain or PTSD to AUD have not explored interactions between pain and PTSD symptoms. Methods: OEF/OIF/OND veterans (N = 1230) were recruited from social media websites for a cross-sectional study of health behavior. Pain was assessed using the Pain Outcomes Questionnaire. PTSD symptoms and PTSD symptom clusters were assessed using the Posttraumatic Stress Disorder Checklist for DSM-5. AUD symptoms were assessed with the AUD Identification Test. Linear regression models were used to test for main and interaction effects in the full sample and separately by sex. Results: Both pain and PTSD symptoms were associated with increased AUD symptomology, though the relationship between pain and AUD was heighted at relatively low PTSD symptoms. With respect to PTSD symptom clusters, re-experiencing and negative cognitions and mood were associated with increased AUD symptomology. Interactions between pain and re-experiencing as well as pain and avoidance were revealed. Results for men mirrored the full sample, while an interaction between pain and negative cognitions and mood was associated with AUD in women. Conclusions: Results highlight associations between AUD, PTSD symptoms, and pain among veterans. While the relationship between pain and AUD appeared stronger in the context of low PTSD symptoms, both pain and PTSD symptoms were associated with increased AUD. Clinicians treating veterans with AUD should address the range of potential comorbidities.

中文翻译：

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OEF/OIF/OND 退伍军人的创伤后应激障碍症状、疼痛和酒精使用障碍之间的关联

背景

酒精使用障碍 (AUD) 在持久自由行动、伊拉克自由行动和新黎明行动 (OEF/OIF/OND) 的退伍军人中普遍存在。疼痛和创伤后应激障碍 (PTSD) 是高度共病的并会增加患 AUD 的风险。先前将疼痛或 PTSD 与 AUD 联系起来的研究并未探索疼痛与 PTSD 症状之间的相互作用。方法：从社交媒体网站招募 OEF/OIF/OND 退伍军人 (N = 1230) 进行健康行为的横断面研究。使用疼痛结果问卷评估疼痛。使用 DSM-5 的创伤后应激障碍检查表评估 PTSD 症状和 PTSD 症状群。使用 AUD 识别测试评估 AUD 症状。线性回归模型用于测试整个样本中的主要和交互作用，并按性别分开。结果：疼痛和 PTSD 症状都与 AUD 症状增加有关，尽管疼痛和 AUD 之间的关系在 PTSD 症状相对较低时升高。关于 PTSD 症状群，重新体验和消极认知和情绪与增加的 AUD 症状相关。揭示了疼痛与重新体验以及疼痛与回避之间的相互作用。男性的结果反映了完整的样本，而疼痛与负面认知和情绪之间的相互作用与女性的 AUD 相关。结论: 结果突出了退伍军人中 AUD、PTSD 症状和疼痛之间的关联。虽然在 PTSD 症状较低的情况下，疼痛和 AUD 之间的关系似乎更强，但疼痛和 PTSD 症状都与 AUD 增加有关。治疗患有 AUD 的退伍军人的临床医生应解决潜在合并症的范围。