Cannabis use is common among individuals with posttraumatic stress disorder (PTSD) symptoms, but its impact on psychiatric symptoms and functioning in this population is unclear. To clarify the clinical and functional correlates of cannabis use in individuals with PTSD symptoms, we analyzed data from the 2019–2020 National Health and Resilience in Veterans Study, a nationally representative survey of U.S. military veterans. Participants with current subthreshold or full PTSD (N = 608) reported on their past-6-month cannabis use and current psychiatric symptoms, functioning, treatment utilization, and PTSD symptom management strategies. Veterans with subthreshold/full PTSD who used cannabis more than weekly were more likely to screen positive for co-occurring depression, anxiety, and suicidal ideation than those who did not use cannabis, ORs = 3.4–3.8, or used cannabis less than weekly, ORs = 2.7–3.7. Veterans who used cannabis more than weekly also scored lower in cognitive functioning than veterans with no use, d = 0.25, or infrequent use, d = 0.71, and were substantially more likely to endorse avoidance coping strategies, ORs = 8.2–12.2, including substance use, OR = 4.4, and behavioral disengagement, ORs = 2.7–9.1, to manage PTSD symptoms. Despite more psychiatric and functional problems, veterans with frequent cannabis use were not more likely to engage in mental health treatment, ORs = 0.87–0.99. The results suggest enhanced cannabis use screening, interventions targeting risky use, and strategies promoting treatment engagement may help ameliorate more severe clinical presentations associated with frequent cannabis use among veterans with subthreshold/full PTSD.

中文翻译：

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患有阈下或阈值创伤后应激障碍的美国退伍军人使用大麻：精神疾病、功能和应对创伤后应激症状的策略

大麻的使用在有创伤后应激障碍 (PTSD) 症状的个体中很常见，但其对这一人群的精神症状和功能的影响尚不清楚。为了阐明在有 PTSD 症状的个体中使用大麻的临床和功能相关性，我们分析了 2019-2020 年退伍军人国家健康和复原力研究的数据，这是一项针对美国退伍军人的全国代表性调查。当前亚阈值或完全 PTSD 的参与者（N= 608) 报告了他们过去 6 个月的大麻使用情况和当前的精神症状、功能、治疗利用和 PTSD 症状管理策略。每周使用大麻超过阈值/完全 PTSD 的退伍军人比不使用大麻（ ORs = 3.4-3.8，或每周使用大麻少于一周）的退伍军人更有可能筛查同时出现的抑郁、焦虑和自杀意念，或s = 2.7–3.7。每周使用大麻超过一周的退伍军人在认知功能方面的得分也低于不使用大麻的退伍军人，d = 0.25，或不经常使用大麻，d = 0.71，并且更有可能支持回避应对策略，OR s = 8.2-12.2，包括物质使用，或= 4.4，以及行为脱离，OR s = 2.7–9.1，以管理 PTSD 症状。尽管有更多的精神和功能问题，但经常使用大麻的退伍军人不太可能进行心理健康治疗，OR s = 0.87-0.99。结果表明，加强大麻使用筛查、针对危险使用的干预措施以及促进治疗参与的策略可能有助于改善与阈下/完全 PTSD 退伍军人频繁使用大麻相关的更严重的临床表现。