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Randazza MP, Ham LS, McKay D. An Analysis of Drinking Motives in the Maintenance of Co-Occurring Obsessive-Compulsive Symptoms and Alcohol Misuse. Subst Use Misuse 2024:1-11. [PMID: 39287099 DOI: 10.1080/10826084.2024.2392558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
Objective: Despite the commonly observed co-occurrence of obsessive-compulsive symptoms (OCS) and substance use in clinical populations, few researchers have examined potential mechanisms which contribute to this relationship. This study assessed the mediating role of drinking motives in the relationship between OCS, alcohol consumption, and its resulting health risks among U.S. adults. Methods: Adult participants (n = 1966; Mage = 47.72, SD = 17.91; 76.30% female; 86.10% non-Hispanic White) sourced from Research Match answered an online questionnaire containing measures related to substance use and anxiety-related symptoms. Results: As hypothesized, there was a significant positive indirect path between OCS and both alcohol consumption and risky alcohol use through coping motives. However, there were also small indirect effects of OCS through social motivations for consumption and conformity motivations for risky alcohol use. Conclusions: These results add evidence that coping motives play a role in OCS and alcohol misuse and highlights the need to also consider drinking motives related to social facilitation and conformity in those with co-occurring OCS and alcohol misuse.
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Affiliation(s)
- Michael P Randazza
- Department of Psychology, Fordham University, Bronx, New York, USA
- Department of Psychological Science, University of Arkansas, Fayetteville, Arkansas, USA
| | - Lindsay S Ham
- Department of Psychological Science, University of Arkansas, Fayetteville, Arkansas, USA
| | - Dean McKay
- Department of Psychology, Fordham University, Bronx, New York, USA
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2
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Walton TO, Graupensperger S, Walker DD, Kaysen D. Alcohol use disorder as a moderator of the relationship between posttraumatic stress disorder and suicidality among military personnel. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:1096-1106. [PMID: 38796793 DOI: 10.1111/acer.15313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 02/02/2024] [Accepted: 03/11/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Alcohol use disorder (AUD), posttraumatic stress disorder (PTSD), and suicide are substantial public health concerns among military service members, yet the nature of their relationships is not well understood. Here, we tested the hypothesis that AUD moderates the relationship between PTSD symptom severity and suicidal ideation. METHODS This secondary analysis uses data collected at baseline for a randomized clinical trial. The sample consists of 160 active-duty service members from three service branches (Army, Air Force, and Navy). All participants met diagnostic criteria for PTSD and were not engaged in evidence-based PTSD treatment at the time of enrollment. Zero-inflated Poisson generalized linear regression models were used to test the associations of PTSD and AUD symptom severity with the presence and severity of suicidal ideation. RESULTS Findings suggest that AUD symptom severity moderates (i.e., amplifies) the relationship between PTSD symptoms and severity of suicidal ideation among military personnel with untreated PTSD. Among service members with mild or absent AUD, we found no significant association between PTSD symptoms and the severity of suicidal ideation. However, when AUD severity was average (i.e., sample mean) or high (mean + 1SD), PTSD symptoms were significantly positively associated with the severity of suicidal ideation. CONCLUSIONS This study highlights the importance of assessing AUD and PTSD as a part of suicide risk evaluations of veterans. The results also provide strong support for the maintenance and further development in the military health system of treatment programs that simultaneously address AUD and PTSD comorbidity.
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Affiliation(s)
- Thomas O Walton
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Scott Graupensperger
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Denise D Walker
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California, USA
- National Center for PTSD, VA Palo Alto Health Care System, Palo Alto, California, USA
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3
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Sistad RE, Livingston NA, Crowe ML, Newberger N, Spitzer E, Brief D, Litwack S, Helmuth E, Roy M, Solhan M, Rosenbloom D, Keane TM. Network analysis of reasons for and against changing alcohol use among veterans engaged in a web-based intervention for hazardous drinking and PTSD symptoms. Addict Behav 2023; 143:107689. [PMID: 36924646 PMCID: PMC10485876 DOI: 10.1016/j.addbeh.2023.107689] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/28/2022] [Accepted: 03/06/2023] [Indexed: 03/12/2023]
Abstract
Better understanding of reasons for and against change may be an effective strategy for supporting drinking reduction or abstinence among Iraq and Afghanistan veterans. The current study explored connections between reasons for and against changing hazardous alcohol use, as well as the relative importance of a given reason. Data from 366 veterans (86% male, 77% White) between the ages of 21 and 56 (M = 31.8, SD = 7.3) were obtained from a nationwide web-based alcohol and posttraumatic stress disorder randomized clinical trial. Participant-generated reasons for and against change were used to estimate two separate network models. The network of motives for changing alcohol use was generally well connected with predominately positive associations. Veterans reporting motivation to change alcohol use to improve functioning, enhance self-worth, and decrease alcohol-related consequences tended to have higher than average motivation to reduce or abstain from alcohol use. Alternatively, the network structure of motives against changing alcohol use demonstrated a nearly equal number of positive and negative associations. Whereas reasons to cope and sleep may imply higher than average motivation to continue drinking the same, veterans reporting reasons to reduce anxiety and have fun tended to have lower than average motivation to continue drinking. The current study may inform content modifications to self-help tools to more quickly and effectively target users' motivations from the beginning. Capitalizing on intervention users' motivations early may promote sustained engagement or improve therapeutic impact among those who only use the intervention for a short period of time.
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Affiliation(s)
- Rebecca E Sistad
- U.S. Department of Veteran Affairs, VA Boston Health Care System, Boston, MA, United States; U.S. Department of Veteran Affairs, Minneapolis VA Health Care System, Minneapolis, MN, United States; Department of Psychiatry, Boston University, School of Medicine, United States.
| | - Nicholas A Livingston
- U.S. Department of Veteran Affairs, VA Boston Health Care System, Boston, MA, United States; Department of Psychiatry, Boston University, School of Medicine, United States; National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, United States.
| | - Michael L Crowe
- U.S. Department of Veteran Affairs, VA Boston Health Care System, Boston, MA, United States; National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, United States
| | - Noam Newberger
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, United States
| | - Elizabeth Spitzer
- Center for Healthcare Organization and Implementation Research, Boston, MA, United States; Harvard Medical School, Harvard University, Boston, MA, United States
| | - Deborah Brief
- U.S. Department of Veteran Affairs, VA Boston Health Care System, Boston, MA, United States; Department of Psychiatry, Boston University, School of Medicine, United States
| | - Scott Litwack
- U.S. Department of Veteran Affairs, VA Boston Health Care System, Boston, MA, United States; Department of Psychiatry, Boston University, School of Medicine, United States
| | - Eric Helmuth
- Educational Development Center, Waltham, MA, United States
| | - Monica Roy
- U.S. Department of Veteran Affairs, VA Boston Health Care System, Boston, MA, United States; Department of Psychiatry, Boston University, School of Medicine, United States
| | - Marika Solhan
- Department of Psychiatry, Boston University, School of Medicine, United States; U.S. Department of Veterans Affairs, Boston Vet Center, Boston, MA, United States
| | - David Rosenbloom
- Boston University School of Public Health, Boston, MA, United States
| | - Terence M Keane
- U.S. Department of Veteran Affairs, VA Boston Health Care System, Boston, MA, United States; Department of Psychiatry, Boston University, School of Medicine, United States; National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, United States
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4
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Prosek EA, Giordano AL, Burgin EE, Valverde N, Hagedorn WB. Predictors of hazardous drinking and internet gaming severity among a military sample. JOURNAL OF ADDICTIONS & OFFENDER COUNSELING 2022. [DOI: 10.1002/jaoc.12114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Elizabeth A. Prosek
- Department of Educational Psychology, Counseling, and Special Education Penn State University University Park Pennsylvania USA
| | - Amanda L. Giordano
- Department of Counseling and Human Development Services University of Georgia Athens Georgia USA
| | - Elizabeth E. Burgin
- Department of School Psychology & Counselor Education William & Mary Williamsburg Virginia USA
| | - Nancy Valverde
- Department of Educational Psychology, Counseling, and Special Education Penn State University University Park Pennsylvania USA
| | - W. Bryce Hagedorn
- Department of Counselor Education & School Psychology University of Central Florida Orange County Pennsylvania USA
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Li Z, He J, Wang Y, Bai M, Zhang Y, Chen H, Li W, Cai Y, Chen S, Qu M, Wang J. A cross-sectional study on the mental health of patients with COVID-19 1 year after discharge in Huanggang, China. Eur Arch Psychiatry Clin Neurosci 2022; 273:301-310. [PMID: 36192452 PMCID: PMC9529163 DOI: 10.1007/s00406-022-01484-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/29/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study is aimed to investigate the mental health status of COVID-19 survivors 1 year after discharge from hospital and reveal the related risk factors. METHODS From April 11 to May 11, 2021, 566 COVID-19 survivors in Huanggang city were recruited through their primary doctors. A total of 535 participants (94.5%) admitted to participate in the survey and completed the questionnaires. Five scales were applied including 7-Items Generalized Anxiety Disorder Scale, Patient Health Questionnaire-9, Impact of Event Scale-Revised, Pittsburgh Sleep Quality Index, and Fatigue Scale-14. The chi-square and the Fisher's exact test were used to evaluate the classification data, multivariate logistic regression was used to explore the related factors of sleep quality, fatigue, anxiety, depression, and post-traumatic stress disorder (PTSD). RESULTS One year after being discharged, of the 535 COVID-19 survivors, 252 (47.1%) had poor sleep quality; 157 (29.3%) had the symptoms of fatigue; 84 (15.7%),112 (20.9%), and 130 (24.3%) suffered from symptoms of anxiety, depression, and PTSD, respectively. The logistic regression analysis showed that history of chronic disease was risk factor for poor sleep quality (OR 2.501; 95% CI, 1.618-3.866), fatigue (OR 3.284; 95% CI 2.143-5.033), PTSD (OR 2.323; 95% CI 1.431-3.773) and depression (OR 1.950; 95% CI 1.106-3.436) in COVID-19 survivors. Smoking contributed to the poor sleep quality (OR 2.005; 95% CI 1.044-3.850), anxiety (OR 4.491; 95% CI 2.276-8.861) and depression (OR 5.459; 95% CI 2.651-11.239) in survivors. Drinking influenced fatigue (OR 2.783; 95% CI 1.331-5.819) and PTSD (OR 4.419; 95% CI 1.990-9.814) in survivors. Compared with college-educated survivors, survivors with high school education were at higher risk for poor sleep quality (OR 1.828; 95% CI 1.050-3.181) and PTSD (OR 2.521; 95% CI 1.316-4.830), and survivors with junior high school education were at higher risk for PTSD (OR 2.078; 95% CI 1.039-4.155). Compared with overweight survivors (BMI ≥ 23.0), survivors with normal BMI (18.5-22.9) (OR 0.600; 95% CI 0.405-0.889) were at lower risk for fatigue. While being housewife (OR 0.390; 95% CI 0.189-0.803) was protective factor for fatigue and having more family members was protective factor for PTSD (OR 0.404 95% CI 0.250-0.653) in survivors. CONCLUSIONS One year after infection, poor sleep quality, fatigue, anxiety, depression, and PTSD, still existed in a relatively high proportion of COVID-19 survivors. Chronic disease history was an independent risk factor for poor sleep quality, fatigue, depression, and PTSD. Participants with low education levels were more likely to have mental problems than the others. We should focus on the long-term psychological impact of COVID-19 on survivors, and the government should apply appropriate mental health services to offer psychiatric support.
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Affiliation(s)
- Zhuqing Li
- National Institute of Traditional Chinese Medicine Constitution and Preventive Treatment of Diseases, Beijing University of Chinese Medicine, Beijing, 100029 China
| | - Jiangming He
- National Institute of Traditional Chinese Medicine Constitution and Preventive Treatment of Diseases, Beijing University of Chinese Medicine, Beijing, 100029 China ,Department of Public Health, Huangzhou General Hospital, Huanggang, 438000 Hubei China
| | - Yaqi Wang
- College of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053 China
| | - Minghua Bai
- National Institute of Traditional Chinese Medicine Constitution and Preventive Treatment of Diseases, Beijing University of Chinese Medicine, Beijing, 100029 China
| | - Ying Zhang
- College of Chinese Medicine, Beijing University of Chinese Medcine, Beijing, 100029 China
| | - Hongshu Chen
- Department of Medical Quality Management, Huangzhou General Hospital, Huanggang, 438000 Hubei China
| | - Wenle Li
- National Institute of Traditional Chinese Medicine Constitution and Preventive Treatment of Diseases, Beijing University of Chinese Medicine, Beijing, 100029 China
| | - Yuyang Cai
- National Institute of Traditional Chinese Medicine Constitution and Preventive Treatment of Diseases, Beijing University of Chinese Medicine, Beijing, 100029 China
| | - Shunqi Chen
- National Institute of Traditional Chinese Medicine Constitution and Preventive Treatment of Diseases, Beijing University of Chinese Medicine, Beijing, 100029 China
| | - Miao Qu
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China.
| | - Ji Wang
- National Institute of Traditional Chinese Medicine Constitution and Preventive Treatment of Diseases, Beijing University of Chinese Medicine, Beijing, 100029, China.
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6
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Luciano MT, Acuff SF, Olin CC, Lewin RK, Strickland JC, McDevitt-Murphy ME, Murphy JG. Posttraumatic stress disorder, drinking to cope, and harmful alcohol use: A multivariate meta-analysis of the self-medication hypothesis. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2022; 131:447-456. [PMID: 35587413 PMCID: PMC9233097 DOI: 10.1037/abn0000764] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The association between posttraumatic stress disorder (PTSD) and harmful alcohol use has often been explained through the self-medication hypothesis via coping-related drinking motives. However, the magnitude of the indirect effect of PTSD on harmful alcohol use through coping motives is unclear. This study aggregated this indirect effect using a meta-analytic structural equation modeling approach and explored moderators that influenced the indirect effect. We identified articles from PsycINFO, PubMed/MEDLINE, and PROQUEST (through June 22, 2021) containing measures of (a) PTSD symptoms, (b) coping-related drinking, and (c) harmful alcohol use. Thirty-four studies yielding 69 effect sizes were included (mean N = 387.26 participants; median N = 303.5; range = 42-1,896; aggregate sample n = 15,128). Coping motives mediated the relation between PTSD and harmful alcohol use, accounting for 80% of the variance in the total effect. Moderating variables and evidence of publication bias were also found. Findings suggest that coping-related drinking is a strong mediator in the relation between PTSD and harmful alcohol use and that the strength of the indirect effect is meaningfully influenced by measurement approach, sample characteristics, and study design. Additional longitudinal and multivariate studies are needed to establish directionality and account for additional variance. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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7
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Gierski F, Benzerouk F, Jeanblanc J, Angerville B, Dervaux A, Kaladjian A, Naassila M. Validity and usefulness of the short form of the Drinking Motives Questionnaire Revised (DMQ-R SF) among patients with schizophrenia. Addict Behav 2022; 129:107251. [PMID: 35093808 DOI: 10.1016/j.addbeh.2022.107251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 12/21/2021] [Accepted: 01/14/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Drinking motives are considered to be major predictors of alcohol consumption and alcohol-related problems. However, these motives have been poorly investigated in patients with schizophrenia. The aim of the present study among patients with schizophrenia was twofold: 1) assess the validity of the short form of the Drinking Motives Questionnaire-Revised (DMQ-R SF); and 2) investigate the relationship between drinking motives and comorbid alcohol use disorder (AUD). METHOD A total of 179 patients with schizophrenia were approached to participate in the study. DSM-5 criteria were used to identify patients with comorbid AUD (AUD+; n = 42) and non-abstainers patients without comorbid AUD (AUD-; n = 71). RESULTS A confirmatory factor analysis conducted on items of the DMQ-R SF for the whole sample revealed adequate goodness-of-fit values, while internal consistency indices were globally satisfactory. Group comparisons revealed higher use of alcohol and other substances, as well as stronger drinking motives among AUD + patients, while groups were comparable concerning clinical features of schizophrenia, including psychotic symptom dimensions and severity. Regression analysis showed that the Alcohol Use Disorder Identification Test score was significantly associated with two internal drinking motives: enhancement and coping. CONCLUSIONS Findings suggest that the DMQ-R SF is a reliable tool for assessing drinking motives among patients with schizophrenia. Enhancement and coping motives seem to play a major role in comorbid AUD among these patients. Community-based and clinical treatment programs should take the drinking motives of dual-diagnosis patients into consideration, in order to improve their outcomes.
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Affiliation(s)
- Fabien Gierski
- Cognition Health Society Laboratory (C2S - EA 6291), University of Reims Champagne Ardenne, Reims, France; Department of Psychiatry, Marne Public Mental Health Institution & Reims University Hospital, Reims, France; Research Group on Alcohol and Dependences, INSERM & University of Picardy Jules Verne, Amiens, France; Department of Psychiatry and Addiction, Amiens University Hospital, Amiens, France; Institute of Psychiatry and Addictions, Paris, France.
| | - Farid Benzerouk
- Cognition Health Society Laboratory (C2S - EA 6291), University of Reims Champagne Ardenne, Reims, France; Department of Psychiatry, Marne Public Mental Health Institution & Reims University Hospital, Reims, France; Institute of Psychiatry and Addictions, Paris, France
| | - Jérôme Jeanblanc
- Research Group on Alcohol and Dependences, INSERM & University of Picardy Jules Verne, Amiens, France; Institute of Psychiatry and Addictions, Paris, France
| | - Bernard Angerville
- Research Group on Alcohol and Dependences, INSERM & University of Picardy Jules Verne, Amiens, France; Department of Psychiatry and Addiction, Amiens University Hospital, Amiens, France; Institute of Psychiatry and Addictions, Paris, France
| | - Alain Dervaux
- Research Group on Alcohol and Dependences, INSERM & University of Picardy Jules Verne, Amiens, France; Department of Psychiatry and Addiction, Amiens University Hospital, Amiens, France; Institute of Psychiatry and Addictions, Paris, France
| | - Arthur Kaladjian
- Cognition Health Society Laboratory (C2S - EA 6291), University of Reims Champagne Ardenne, Reims, France; Department of Psychiatry, Marne Public Mental Health Institution & Reims University Hospital, Reims, France; Institute of Psychiatry and Addictions, Paris, France
| | - Mickaël Naassila
- Research Group on Alcohol and Dependences, INSERM & University of Picardy Jules Verne, Amiens, France; Institute of Psychiatry and Addictions, Paris, France
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Palmisano AN, Norman SB, Panza KE, Petrakis IL, Pietrzak RH. PTSD symptom heterogeneity and alcohol-related outcomes in U.S. military veterans: Indirect associations with coping strategies. J Anxiety Disord 2022; 85:102496. [PMID: 34775167 DOI: 10.1016/j.janxdis.2021.102496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 10/22/2021] [Accepted: 11/01/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION This study investigated the role of coping strategies in mediating the relationship between the 7-factor model of posttraumatic stress disorder (PTSD) symptoms and alcohol misuse in veterans. METHODS Data were analyzed from 615 veterans from a nationally representative study of U.S. veterans who met criteria for probable full or subthreshold PTSD. Path analyses examined the role of self-sufficient, socially-supported, and avoidant coping strategies in mediating associations between PTSD symptom clusters and alcohol use disorder (AUD), alcohol consumption, and alcohol-related consequences. RESULTS Negative affect PTSD symptoms were associated with AUD through increased use of avoidant coping. Additionally, dysphoric arousal PTSD symptoms were associated with AUD; avoidant coping was associated with AUD and increased alcohol consumption; self-sufficient coping was associated with reduced AUD likelihood anhedonia symptoms with decreased use of self-sufficient coping; and negative affect with decreased use of socially-supported coping and increased use of avoidant coping. CONCLUSIONS Results underscore the importance of avoidant coping strategies as potential mediators of the relation between PTSD symptoms and AUD. Interventions designed to mitigate engagement in avoidant coping strategies, and to bolster engagement in self-sufficient and socially-supported strategies may help reduce alcohol misuse in veterans with full or subthreshold PTSD.
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Affiliation(s)
- Alexandra N Palmisano
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; US Department of Veteran Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA.
| | - Sonya B Norman
- Department of Psychiatry, University of California, San Diego, CA, USA; VA Center of Excellence for Stress and Mental Health, San Diego, CA, USA; US Department of Veteran Affairs National Center for Posttraumatic Stress Disorder, White River Junction, VT, USA; VA San Diego Healthcare System, San Diego, CA
| | - Kaitlyn E Panza
- Department of Psychiatry, University of California, San Diego, CA, USA; VA San Diego Healthcare System, San Diego, CA
| | - Ismene L Petrakis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; US Department of Veteran Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; US Department of Veteran Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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9
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Saba SK, Davis JP, Prindle JJ, Castro CA, Pedersen ER. Associations between symptoms of posttraumatic stress disorder, pain, and alcohol use disorder among OEF/OIF/OND veterans. Addict Behav 2021; 122:107031. [PMID: 34237611 DOI: 10.1016/j.addbeh.2021.107031] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/17/2021] [Accepted: 06/24/2021] [Indexed: 11/18/2022]
Abstract
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.
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Affiliation(s)
- Shaddy K Saba
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W. 34(th) St, Los Angeles, CA 90089, United States.
| | - Jordan P Davis
- University of Southern California, Suzanne Dworak-Peck School of Social Work, USC Center for Artificial Intelligence in Society, USC Center for Artificial Intelligence in Society, USC Institute for Addiction Science, 669 W. 34(th) St, Los Angeles, CA 90089, United States
| | - John J Prindle
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W. 34(th) St, Los Angeles, CA 90089, United States
| | - Carl Andrew Castro
- Center for Innovation and Research on Veterans and Military Families, University of Southern California Suzanne-Dworak-Peck School of Social Work, 669 W. 34(th) St, Los Angeles, CA 90089, United States
| | - Eric R Pedersen
- University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, 2250 Alcazar Street, Suite 2200, Los Angeles, CA 90033, United States
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10
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Blakey SM, Tsai J, Elbogen EB. Drinking to Cope with Posttraumatic Stress: A Nationally Representative Study of Men with and without Military Combat Experience. J Dual Diagn 2021; 17:101-112. [PMID: 33730991 DOI: 10.1080/15504263.2021.1891360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Posttraumatic stress disorder (PTSD) and hazardous alcohol use are prevalent among trauma survivors. Despite higher rates of both PTSD and hazardous alcohol use among military combat veterans than civilians, scant research has examined whether military combat experience is associated with drinking alcohol to cope with PTSD symptoms. This study tested the hypothesis that compared to trauma-exposed men without combat experience, men with military combat experience would be more likely to endorse drinking alcohol to cope with their PTSD symptoms. Methods: Interview data from N = 11,474 men who reported at least one lifetime traumatic experience were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a face-to-face interview study that recruited a nationally representative sample of adults living in the United States between 2004 and 2005. Results: Among men endorsing lifetime trauma exposure, men with military combat experience (n = 1,386) were more likely than men without combat experience (n = 10,088) to report drinking alcohol to cope (7.22 vs. 2.61% in unweighted analyses, 6.46 vs. 2.37% in weighted analyses). Total number of lifetime trauma types, lifetime PTSD severity, and lifetime alcohol abuse/dependence were significantly associated with drinking to cope in bivariate and multivariate analyses. Military combat experience was significantly associated with drinking to cope in multivariate analyses adjusting for lifetime PTSD diagnosis. Military combat experience was not significantly associated with drinking to cope in multivariate analyses adjusting for lifetime PTSD symptom count. Conclusions: Although military combat experience was significantly associated with drinking to cope in bivariate analyses, multivariate analyses yielded mixed findings: combat experience was significantly associated with drinking to cope in models adjusting for PTSD diagnosis, but not in models adjusting for PTSD symptom count. Findings highlight the importance of assessing and targeting PTSD symptom-related alcohol use, even in the absence of alcohol abuse/dependence. Results from this preliminary study could inform future research on drinking to cope with PTSD symptoms among military combat veterans and other trauma survivors.
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Affiliation(s)
- Shannon M Blakey
- Durham VA Health Care System, Durham, North Carolina, USA.,VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, North Carolina, USA
| | - Jack Tsai
- School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA.,VA National Center on Homelessness Among Veterans, Tampa, Florida, USA
| | - Eric B Elbogen
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, North Carolina, USA.,VA National Center on Homelessness Among Veterans, Tampa, Florida, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
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11
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Kasten CR, Holmgren EB, Lerner MR, Wills TA. BNST specific mGlu5 receptor knockdown regulates sex-dependent expression of negative affect produced by adolescent ethanol exposure and adult stress. Transl Psychiatry 2021; 11:178. [PMID: 33731684 PMCID: PMC7969933 DOI: 10.1038/s41398-021-01285-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 01/21/2021] [Accepted: 02/18/2021] [Indexed: 12/11/2022] Open
Abstract
Adolescent alcohol use is one of the strongest predictors for the development of an alcohol use disorder (AUD). Notably, this period of risk coincides with the development of affective disorders, which disproportionately impact and drive problematic drinking behavior in women. Stress is a particularly salient factor that drives relapse during periods of abstinence. Previous work in our lab has shown that adolescent intermittent ethanol vapor (AIE) produces sex-dependent changes in glutamatergic activity in the bed nucleus of the stria terminalis (BNST) and behavioral outcomes following acute restraint stress in adulthood. In females, AIE disrupts group 1 metabotropic glutamate (mGlu1/5) receptor activity and enhances anhedonia-like behavior. The current study site-specifically knocked down mGlu5 receptors in the BNST of male and female Grm5loxp mice, exposed them to AIE, and observed the interaction of AIE and stress on negative affect-like behaviors in adulthood. These negative affect-like behaviors included the novelty-induced hypophagia task following acute restraint stress, open field activity, and contextual fear conditioning. Overall, we replicated our previous findings that AIE enhanced anhedonia-like activity in the novelty-induced hypophagia task in females and fear acquisition in males. The primary effect of BNST-mGlu5 receptor knockdown was that it independently enhanced anhedonia-like activity in females. Correlation analyses revealed that behavior in these paradigms showed poor interdependence. These results indicate that preclinical models of negative affective-like states encompass distinct features that may have independent, clinically relevant mechanisms. Further, modulating mGlu5 receptors is a prospective treatment target for females experiencing anhedonic-like states that make them susceptible to alcohol relapse.
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Affiliation(s)
- Chelsea R Kasten
- Department of Cell Biology and Anatomy, LSU Health Sciences Center New Orleans, New Orleans, LA, USA
| | - Eleanor B Holmgren
- Department of Cell Biology and Anatomy, LSU Health Sciences Center New Orleans, New Orleans, LA, USA
| | - Mollie R Lerner
- Department of Cell Biology and Anatomy, LSU Health Sciences Center New Orleans, New Orleans, LA, USA
| | - Tiffany A Wills
- Department of Cell Biology and Anatomy, LSU Health Sciences Center New Orleans, New Orleans, LA, USA.
- Neuroscience Center of Excellence, LSU Health Sciences Center New Orleans, New Orleans, LA, USA.
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12
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Jessup SC, Blakey SM, Abramowitz JS. Anxiety sensitivity and posttraumatic stress symptoms in sexual assault survivors. Bull Menninger Clin 2020; 84:197-213. [PMID: 33000967 DOI: 10.1521/bumc.2020.84.3.197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Anxiety sensitivity (AS), the fear of anxiety-related physiological sensations, is a predictor of posttraumatic stress symptoms (PTSS) following a traumatic event, yet there is limited research on the relationship between AS and PTSS among sexual assault survivors. The present study was designed to test the hypothesis that AS would emerge as a statistical predictor of PTSS dimensions among community members and undergraduate students endorsing lifetime exposure to sexual trauma. Adults endorsing a history of sexual assault (N = 52) completed an online battery, including self-report measures of AS, general distress, dysfunctional trauma-related beliefs (i.e., posttraumatic cognitions), and PTSS. Although AS was associated with PTSS dimensions at the bivariate level (rs ranged .68-82), AS did not emerge as a significant unique predictor of PTSS dimensions in linear regression analyses after controlling for general distress and posttraumatic cognitions. In fact, general distress was the only significant statistical predictor of PTSS total and dimension scores (ps < 01). Study implications, limitations, and future directions are discussed.
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Affiliation(s)
- Sarah C Jessup
- Graduate Student, Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill.,Vanderbilt University, Nashville, Tennessee
| | - Shannon M Blakey
- Postdoctoral fellow, Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Jonathan S Abramowitz
- Professor of psychology, Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
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13
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Luk JW, LaCroix JM, Thompson MF, Darmour C, Perera KU, Goldston D, Soumoff A, Weaver J, Ghahramanlou-Holloway M. Hazardous drinking and clinical correlates among suicidal patients receiving psychiatric inpatient care at military medical settings. Addict Behav 2020; 102:106178. [PMID: 31783246 DOI: 10.1016/j.addbeh.2019.106178] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 09/19/2019] [Accepted: 10/11/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND To describe prevalence and identify clinical correlates of hazardous drinking among suicidal inpatients at military medical settings. METHOD Data were drawn from the baseline assessment of a multisite randomized controlled trial of Post-Admission Cognitive Therapy (PACT). Participants were military Service members or adult beneficiaries (N = 218) who were admitted to inpatient care following a suicide-related crisis. Hazardous alcohol use in the past year was assessed using the Alcohol Use Disorder Identification Test (AUDIT). RESULTS The average AUDIT score was 6.78 (SD = 7.87), with 28.9% reporting hazardous drinking (scored ≥8 on the AUDIT). Hazardous drinkers were more likely than nonhazardous drinkers to meet diagnosis of Substance Use Disorder (SUD; Odds Ratio [OR] = 5.96, 95% confidence intervals [CI] = 2.13, 16.71). Hazardous drinking was neither associated with measures of suicide ideation nor aborted or interrupted suicide attempt. However, hazardous drinkers had greater risk of having both single (RRR [Relative Risk Ratio] = 2.55, 95% CI = 1.18, 5.50) and multiple actual suicide attempts (RRR = 2.38, 95% CI = 1.06, 5.32) than nonhazardous drinkers. The association between hazardous drinking and single (but not multiple) actual suicide attempt remained significant after controlling for gender, depressive symptoms, hopelessness, Post-Traumatic Stress Disorder, and SUD (adjusted RRR = 2.48, 95% CI = 1.09, 5.65). CONCLUSIONS A history of actual suicide attempt is associated with hazardous alcohol use among suicidal psychiatric inpatients. Assessment of drinking and drug use may inform case conceptualization and treatment of suicide-related behaviors in psychiatric inpatient settings.
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14
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Gauthier JM, Cole AB, Bagge CL. A preliminary examination of the association between drinking as a typical coping strategy and level of acute alcohol consumption prior to a suicide attempt. Psychiatry Res 2019; 282:112626. [PMID: 31685287 PMCID: PMC6923992 DOI: 10.1016/j.psychres.2019.112626] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 10/17/2019] [Accepted: 10/19/2019] [Indexed: 01/02/2023]
Abstract
Drinking to cope is associated with suicide ideation and attempts. Event-based research shows drinking, particularly when alcohol is consumed in large quantities, increases the intensity of suicidal thoughts and immediate risk for attempt. Such findings suggest those who typically drink to cope may be especially likely to drink heavily in the hours preceding a suicide attempt. In the first examination of the association between regular use of alcohol as a coping strategy and acute alcohol consumption prior to a suicide attempt, participants included 130 patients hospitalized for a recent attempt. The number of drinks consumed in the acute period preceding the attempt, as well as past-year heavy drinking frequency, typical drinking motives, and depressive symptoms were assessed. The unique impacts of coping motives on odds of consuming any alcohol, and of using specific amounts of alcohol in the acute period, were determined through binary and multinomial logistic regressions. Results demonstrated that commonly drinking for coping motives increased the odds of heavy drinking - but not of using alcohol at low levels - during the acute period. Results held after adjusting for relevant covariates. Clinicians should assess drinking motives and prioritize prevention of drinking to cope to reduce risk of alcohol-related suicide attempts.
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Affiliation(s)
- Jami M Gauthier
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States; Substance Abuse Treatment Program, Atlanta VA Medical Center, Atlanta, GA, United States.
| | - Ashley B Cole
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States; Department of Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Courtney L Bagge
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States; Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, MI, United States; Center for Clinical Management Research, Ann Arbor VA, Ann Arbor, MI, United States
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15
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Puddephatt JA, Leightley D, Palmer L, Jones N, Mahmoodi T, Drummond C, Rona RJ, Fear NT, Field M, Goodwin L. A Qualitative Evaluation of the Acceptability of a Tailored Smartphone Alcohol Intervention for a Military Population: Information About Drinking for Ex-Serving Personnel (InDEx) App. JMIR Mhealth Uhealth 2019; 7:e12267. [PMID: 31127726 PMCID: PMC6555114 DOI: 10.2196/12267] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 03/05/2019] [Accepted: 03/30/2019] [Indexed: 02/06/2023] Open
Abstract
Background Alcohol consumption in the UK Armed Forces is higher than in the general population, and this pattern continues after leaving the service. Smartphone apps may be useful to increase ex-serving personnel’s awareness of their alcohol consumption, support self-monitoring, and prompt a change in behavior. Objective The study aimed to explore the acceptability of Information about Drinking in Ex-serving personnel (InDEx), a tailored smartphone app, combined with personalized short message service (SMS) text messaging designed to target ex-serving personnel who meet the criteria for hazardous alcohol use. Methods The InDEx intervention included 4 key modules: (1) assessment and normative feedback, (2) self-monitoring and feedback, (3) goal setting and review, and (4) personalized SMS text messaging. A semistructured telephone interview study was conducted with ex-serving personnel after using the app for a 28-day period. Interviews were used to explore the acceptability of app modules and its functionality and the perceived changes in participant’s drinking. Interview transcripts were analyzed using inductive thematic analysis. Results Overall, 94% (29/31) participants who used InDEx agreed to take part in a telephone interview. Overall, 4 themes were identified: Credibility, Meeting their needs, Simplicity, and Helpful for ex-serving personnel. The importance of credibility, functionality, and meeting the individual needs of ex-serving personnel was emphasized. Acceptability and engagement with specific modules of the app and text messages were influenced by the following: (1) if they felt it provided credible information, (2) whether the content was appropriately personalized to them, (3) the ease of use, and (4) beliefs about their own drinking behaviors. Participants recommended that the app would be most suitable for personnel about to leave the Armed Forces. Conclusions InDEx was an acceptable smartphone app for ex-serving personnel for monitoring alcohol consumption and in providing meaningful feedback to the individual. Pages that met the participant’s interests and provided real time personalized, credible feedback on their drinking and text messages tailored to participant’s interactions with the app were particularly favored.
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Affiliation(s)
- Jo-Anne Puddephatt
- Department of Psychological Sciences, Institute of Life and Human Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Daniel Leightley
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Laura Palmer
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Norman Jones
- Academic Department of Military Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Toktam Mahmoodi
- Department of Informatics, King's College London, London, United Kingdom
| | - Colin Drummond
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Roberto J Rona
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Nicola T Fear
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,Academic Department of Military Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Matt Field
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Laura Goodwin
- Department of Psychological Sciences, Institute of Life and Human Sciences, University of Liverpool, Liverpool, United Kingdom
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16
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Nishith P, Mueser KT, Morse GA. Alcohol expectancies in persons with severe mental illness and posttraumatic stress disorder. COGENT MEDICINE 2019. [DOI: 10.1080/2331205x.2019.1635805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Pallavi Nishith
- Places for People: A human Approach to Mental Health+Healing, St. Louis, MO, USA
| | - Kim T. Mueser
- Center for Psychiatric Rehabilitation, Boston University, Boston, MA, USA
| | - Gary A. Morse
- Places for People: A human Approach to Mental Health+Healing, St. Louis, MO, USA
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17
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Alcohol expectancies and distress tolerance: Potential mechanisms in the relationship between posttraumatic stress and alcohol use. PERSONALITY AND INDIVIDUAL DIFFERENCES 2019. [DOI: 10.1016/j.paid.2018.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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18
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Szafranski DD, Gros DF, Acierno R, Brady KT, Killeen TK, Back SE. Heterogeneity of treatment dropout: PTSD, depression, and alcohol use disorder reductions in PTSD and AUD/SUD treatment noncompleters. Clin Psychol Psychother 2018; 26:218-226. [DOI: 10.1002/cpp.2344] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 10/11/2018] [Accepted: 10/11/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Derek D. Szafranski
- Ralph H. Johnson Veterans Affairs Medical CenterMental Health Service 116, General Mental Health 109 Bee Street Charleston SC 29401 USA
- Department of Psychiatry and Behavioral SciencesMedical University of South Carolina Charleston South Carolina USA
| | - Daniel F. Gros
- Ralph H. Johnson Veterans Affairs Medical CenterMental Health Service 116, General Mental Health 109 Bee Street Charleston SC 29401 USA
- Department of Psychiatry and Behavioral SciencesMedical University of South Carolina Charleston South Carolina USA
| | - Ron Acierno
- Ralph H. Johnson Veterans Affairs Medical CenterMental Health Service 116, General Mental Health 109 Bee Street Charleston SC 29401 USA
- College of NursingMedical University of South Carolina Charleston South Carolina USA
| | - Kathleen T. Brady
- Ralph H. Johnson Veterans Affairs Medical CenterMental Health Service 116, General Mental Health 109 Bee Street Charleston SC 29401 USA
- Department of Psychiatry and Behavioral SciencesMedical University of South Carolina Charleston South Carolina USA
| | - Therese K. Killeen
- Department of Psychiatry and Behavioral SciencesMedical University of South Carolina Charleston South Carolina USA
| | - Sudie E. Back
- Ralph H. Johnson Veterans Affairs Medical CenterMental Health Service 116, General Mental Health 109 Bee Street Charleston SC 29401 USA
- Department of Psychiatry and Behavioral SciencesMedical University of South Carolina Charleston South Carolina USA
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