Abstract

Objective: The high comorbidity between posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) is well-established and complex. However, there is a need to explore transdiagnostic constructs that may underlie this association to better understand what accounts for this comorbidity and to inform treatment development. Method: Thus, the present study utilized a large, cross-sectional dataset (N = 513; M_age = 38.25 years, SD = 10.07; 49.9% female), based on national recruitment, to (1) examine whether the associations between PTSD symptom severity (PCL-5) and alcohol use severity (AUDIT) were statistically mediated by (a) anxiety sensitivity (SSASI); and (b) difficulties with emotion regulation (DERS-16); and (2) examine whether coping motives for drinking moderate this indirect effect. Sex assigned at birth was included as a covariate. Results: When examining the hypothesized mediators (SSASI and DERS-16) in separate models, there was a statistically significant indirect effect of PCL-5 on AUDIT through both SSASI and DERS. However, when both SSASI and DERS were entered into a model simultaneously, only SSASI served as a statistically significant mediator. Coping motives for drinking did not moderate the observed indirect effect. Conclusions: The current findings highlight anxiety sensitivity and emotion regulation as transdiagnostic processes that may explain, at least partially, the relationship between PTSD symptom severity and alcohol use; however, stronger evidence was evident for anxiety sensitivity. These findings may help inform the development of refined, streamlined interventions for PTSD and alcohol use that directly target these processes.

摘要

目的：创伤后应激障碍 (PTSD) 和酒精使用障碍 (AUD) 之间的高合并症是明确且复杂的。然而，有必要探索可能构成这种关联的跨诊断结构，以更好地了解导致这种合并症的原因并为治疗开发提供信息。方法：因此，本研究利用 基于全国招募的大型横截面数据集（N  = 513；M _{ag e} = 38.25 岁，SD = 10.07；49.9% 女性），以 (1) 检查PTSD 症状严重程度 (PCL-5) 和饮酒严重程度 (AUDIT) 在统计学上是由 (a) 焦虑敏感性 (SSASI) 介导的；(b) 情绪调节困难 (DERS-16)；(2) 检查饮酒的应对动机是否减轻了这种间接影响。出生时指定的性别被列为协变量。结果：在单独的模型中检查假设的中介变量（SSASI 和 DERS-16）时，PCL-5 通过 SSASI 和 DERS 对 AUDIT 产生统计上显着的间接影响。然而，当 SSASI 和 DERS 同时输入模型时，只有 SSASI 充当统计显着中介。应对饮酒的动机并没有减轻观察到的间接影响。结论：目前的研究结果强调焦虑敏感性和情绪调节作为跨诊断过程，可以至少部分解释 PTSD 症状严重程度与饮酒之间的关系；然而，对于焦虑敏感性，更有力的证据是显而易见的。这些发现可能有助于为直接针对这些过程的创伤后应激障碍和酒精使用制定精致、简化的干预措施。