AURORA创伤幸存者观察队列研究中的创伤前失眠和创伤后酒精和大麻使用

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research Pub Date : 2025-06-20 DOI:10.1016/j.jpsychires.2025.06.027

Nicole A. Short , Robyn A. Ellis , Mattea Pezza , Stacey L. House , Francesca L. Beaudoin , Xinming An , Gari D. Clifford , Tanja Jovanovic , Sarah D. Linnstaedt , Scott L. Rauch , John P. Haran , Alan B. Storrow , Christopher Lewandowski , Paul I. Musey , Phyllis L. Hendry , Sophia Sheikh , Christopher W. Jones , Brittany E. Punches , Lauren A. Hudak , Jose L. Pascual , Thomas C. Neylan

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引用次数: 0

摘要

背景和目的睡眠症状是使用酒精和大麻的一个潜在危险因素，特别是在创伤暴露人群中。创伤后最初的几周和几个月是有问题物质使用的风险时期，然而先前的研究并没有检查失眠症状是否预示着创伤后酒精或大麻的使用。设计：本研究对急诊创伤幸存者进行了大规模、多地点、前瞻性研究，测试了创伤前失眠症状、两周创伤后应激障碍（PTSD）症状和创伤后八周大量饮酒、大麻使用和酗酒之间的直接和间接联系。参与者从美国的23个急诊室招募，并使用远程评估进行随访。参与者/病例：参与者来自AURORA研究（n = 2449）。女性略占多数（63.8%），平均年龄为37岁。参与者的种族和民族多样化（50.5%为黑人，11.2%为西班牙裔）。测量：参与者在急诊科就诊期间以及创伤后两周和八周完成自我报告测量。发现创伤前失眠症状显著预示着创伤后8周大量饮酒和吸食大麻，以及酗酒。在急救时，创伤前物质使用、人口统计变量和创伤严重程度共变后，相关性仍然存在。此外，创伤前失眠症状与创伤后8周大量饮酒和使用大麻之间的关联在创伤后两周的创伤后应激障碍症状中得到显著调节。结论睡眠症状可能是创伤后重度酒精和大麻使用及酗酒的重要延展性危险因素。需要进一步的研究来探索失眠干预在减轻创伤后物质使用方面的有效性，并更好地理解睡眠、创伤、创伤后应激障碍和物质使用之间的复杂关系。

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Pre-trauma insomnia and posttraumatic alcohol and cannabis use in the AURORA observational cohort study of trauma survivors

Background and aims

Insomnia symptoms are a potential risk factor for alcohol and cannabis use, particularly in trauma-exposed populations. The initial weeks and months after trauma are a period of risk for problematic substance use, however prior research has not examined whether insomnia symptoms predict alcohol or cannabis use after trauma.

Design

Using a large-scale, multi-site, prospective study of trauma survivors presenting to emergency departments (EDs), the current study tested direct and indirect associations between pre-trauma insomnia symptoms, two-week posttraumatic stress disorder (PTSD) symptoms, and eight-week post-trauma heavy alcohol and cannabis use and binge drinking.

Setting

Participants were recruited from 23 EDs in the United States and followed up using remote assessments.

Participants/cases

Participants were from the AURORA study (n = 2449). A slight majority were women (63.8 %) and were an average of 37 years old. Participants were racially and ethnically diverse (50.5 % Black, 11.2 % Hispanic).

Measurements

Participants completed self-report measures during their ED visit, and two- and eight-weeks post-trauma.

Findings

Pre-trauma insomnia symptoms significantly predicted eight-week post-trauma heavy alcohol and cannabis use, as well as binge drinking. Associations persisted after covarying for pre-trauma substance use, demographic variables, and trauma severity at the time of emergency care. Further, the association between pre-trauma insomnia symptoms and heavy alcohol and cannabis use at eight-weeks post-trauma was significantly mediated by two-week PTSD symptoms.

Conclusions

Insomnia symptoms may be an important malleable risk factor for heavy alcohol and cannabis use and binge drinking after trauma. Further research is needed to explore the effectiveness of insomnia interventions to mitigate post-trauma substance use and to better understand the complex relationships between sleep, trauma, PTSD, and substance use.

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来源期刊

Journal of psychiatric research 医学-精神病学

CiteScore

7.30

自引率

2.10%

发文量

622

审稿时长

130 days

期刊介绍： Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;