월남전 참전자에서 문제음주와 관련한 외상 후 스트레스 장애의 증상 차이
Symptoms of Posttraumatic Stress Disorder in Relation to the Alcohol Problem in Korean Veterans of Vietnam War
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objectives : The three symptom clusters of posttraumatic stress disorder (PTSD) are reexperience, avoidance, and hyperarousal. Alcohol use disorders frequently co-occur with PTSD, and possible functional correlations are suspected. Scholarly evaluation of the differences between the symptoms of PTSD and those of alcohol problems may be useful in understanding the pathophysiology of the comorbidity. Methods : We recruited Vietnam veterans with PTSD (n=97) and without PTSD (n=132). The alcohol use disorder identification test (AUDIT), and clinician-administered PTSD scale (CAPS) were administered to participants. The PTSD group was divided into two categories: those with PTSD only (n=57) and those with concurrent alcohol-related problems (n=40). Results : The PTSD group showed higher AUDIT scores compared to the control group. In the PTSD group, participants with alcohol problems had a severer symptoms of recurrent dream and sleep disturbance symptoms compared to the PTSD only group. No significant differences were found in the three major symptom clusters of PTSD. Conclusion : These findings support the proposed existence of a functional correlation between PTSD and alcohol use disorder. Clinicians should carefully evaluate and treat comorbid alcohol use disorder in patients with PTSD. (Anxiety and Mood 2011;7(2):119-125)
Abstract
Objectives : The three symptom clusters of posttraumatic stress disorder (PTSD) are reexperience, avoidance, and hyperarousal. Alcohol use disorders frequently co-occur with PTSD, and possible functional correlations are suspected. Scholarly evaluation of the differences between the symptoms of PTSD and those of alcohol problems may be useful in understanding the pathophysiology of the comorbidity. Methods : We recruited Vietnam veterans with PTSD (n=97) and without PTSD (n=132). The alcohol use disorder identification test (AUDIT), and clinician-administered PTSD scale (CAPS) were administered to participants. The PTSD group was divided into two categories: those with PTSD only (n=57) and those with concurrent alcohol-related problems (n=40). Results : The PTSD group showed higher AUDIT scores compared to the control group. In the PTSD group, participants with alcohol problems had a severer symptoms of recurrent dream and sleep disturbance symptoms compared to the PTSD only group. No significant differences were found in the three major symptom clusters of PTSD. Conclusion : These findings support the proposed existence of a functional correlation between PTSD and alcohol use disorder. Clinicians should carefully evaluate and treat comorbid alcohol use disorder in patients with PTSD. (Anxiety and Mood 2011;7(2):119-125)
참고문헌 (38)
- American Psychiatric Association, "Diagnostic and Statistical Manual of Mental Disorders-IV-TR" (2000), American Psychiatric Association
- Charney DS, "Psychobiologic mechanisms of posttraumatic stress disorder", Arch Gen Psychiatry, 50, pp.295~305 (1993)
- Chilcoat HD, "Posttraumatic stress disorder and drug disorders: testing causal pathways", Arch Gen Psychiatry, 55, pp.913~917 (1998)
- Breslau N, "Posttraumatic stress disorder and the incidence of nicotine, alcohol, and other drug disorders in persons who have experienced trauma", Arch Gen Psychiatry, 60, pp.289~294 (2003)
- Brady KT, "Posttraumatic stress disorder and comorbidity: recognizing the many faces of PTSD", J Clin Psychiatry, 58(9), pp.12~15 (1997)
- Kessler RC, "Posttraumatic stress disorder in the National Comorbidity Survey", Arch Gen Psychiatry, 52, pp.1048~1060 (1995)
- Leeies M, "The use of alcohol and drugs to self-medicate symptoms of posttraumatic stress disorder", Depress Anxiety, 27, pp.731~736 (2010)
- Lee JY, "Consumption of alcohol, cigarettes, and drugs in patients with posttraumatic stress disorder-Korean multicenter hospital samples", Anxiety and Mood, 3, pp.41~45 (2007)
- Cottler LB, "Posttraumatic stress disorder among substance users from the general population", Am J Psychiatry, 149, pp.664~670 (1992)
- Khantzian EJ, "The self-medication hypothesis of addictive disorders: focus on heroin and cocaine dependence", Am J Psychiatry, 142, pp.1259~1264 (1985)
- Hooper R, "Cigarette and alcohol use in the UK Armed Forces, and their association with combat exposures: a prospective study", Addict Behav, 33, pp.1067~1071 (2008)
- Jacobson IG, "Alcohol use and alcohol-related problems before and after military combat deployment", JAMA, 300, pp.663~675 (2008)
- Hutchison KE, "Prepulse inhibition of the startle reflex: preliminary study of the effects of a low dose of alcohol in humans", Alcohol Clin Exp Res, 21, pp.1312~1319 (1997)
- McFall ME, "Combat-related posttraumatic stress disorder and severity of substance abuse in Vietnam veterans", J Stud Alcohol, 53, pp.357~363 (1992)
- Back SE, "Comparative profiles of women with PTSD and comorbid cocaine or alcohol dependence", Am J Drug Alcohol Abuse, 29, pp.169~189 (2003)
- Saladin ME, "Understanding comorbidity between PTSD and substance use disorders: two preliminary investigations", Addict Behav, 20, pp.643~655 (1995)
- Stewart SH, "The relations of PTSD symptoms to alcohol use and coping drinking in volunteers who responded to the Swissair Flight 111 airline disaster", J Anxiety Disord, 18, pp.51~68 (2004)
- Simons JS, "Associations between alcohol use and PTSD symptoms among American Red Cross disaster relief workers responding to the 9", 11, Am J Drug Alcohol Abuse, pp.2005 (2001), 31[DOI]
- Maguen S, "PTSD subclusters and functional impairment in Kosovo peacekeepers", Mil Med, 174, pp.779~785 (2009)
- Hien DA, "The role of alcohol misuse in PTSD outcomes for women in community treatment: a secondary analysis of NIDA’s Women and Trauma Study", Drug Alcohol Depend, 111, pp.114~119 (2010)
- Jakupcak M, "PTSD symptom clusters in relationship to alcohol misuse among Iraq and Afghanistan war veterans seeking post-deployment VA health care", Addict Behav, 35, pp.840~843 (2010)
- Shipherd JC, "Predicting alcohol and drug abuse in Persian Gulf War veterans: what role do PTSD symptoms play", Addict Behav, 30, pp.595~599 (2005)
- 김정아, "한국 소방관의 음주 양태와 외상후 스트레스 장애 증상, 심리적 강인성, 대처방식과의 관련성", 신경정신의학, 48(6), pp.467~472 (2009), 대한신경정신의학회
- Lee SE, "Alcohol use and drinking motives in patients with posttraumatic stress disorder", J Korean Academy of Addiction Psychiatry, 14, pp.63~69 (2010)
- Blake DD, "The development of a Clinician-Administered PTSD Scale", J Trauma Stress, 8, pp.75~90 (1995)
- Lee BY, "A reliability and validity study of a Clinician-Administered PTSD Scale", J Korean Neuropsychiatr Assoc, 38, pp.514~521 (1999)
- Weathers FW, "Psychometric properties of Nine scoring rules for the Clinician-Administered Posttraumatic stress disorder Scale", Psychol Assess, 11, pp.124~133 (1999)
- Blanchard EB, "Effects of varying scoring rules of the Clinician-Administered PTSD Scale (CAPS) for the diagnosis of post-traumatic stress disorder in motor vehicle accident victims", Behav Res Ther, 33, pp.471~475 (1995)
- Saunders JB, "Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption--II", Addiction, 88, pp.791~804 (1993)
- Lee BO, "Development of Korean version of Alcohol Use Disorders Identification Test (AUDIT-K): Its reliability and validity", J Korean Academy of Addiction Psychiatry, 4, pp.83~92 (2000)
- Keane TM, "Clinical evaluation of a measure to assess combat exposure", Psychol Assess, 1, pp.53~55 (1989)
- Elhai JD, "Which instruments are most commonly used to assess traumatic event exposure and posttraumatic effects?: A survey of traumatic stress professionals", J Trauma Stress, 18, pp.541~545 (2005)
- McFarlane AC, "A longitudinal analysis of alcohol consumption and the risk of posttraumatic symptoms", J Affect Disord, 118, pp.166~172 (2009)
- Stein MD, "Disturbed sleep and its relationship to alcohol use", Subst Abus, 26, pp.1~13 (2005)
- Roehrs T, "Ethanol as a hypnotic in insomniacs: self administration and effects on sleep and mood", Neuropsychopharmacology, 20, pp.279~286 (1999)
- Andrews B, "Comparison of immediate-onset and delayed-onset posttraumatic stress disorder in military veterans", J Abnorm Psychol, 118, pp.767~777 (2009)
- Adinoff B, "Disturbances of the stress response: the role of the HPA axis during alcohol withdrawal and abstinence", Alcohol Health Res World, 22, pp.67~72 (1998)
- Gold PB, "Compensation-seeking and extreme exaggeration of psychopathology among combat veterans evaluated for posttraumatic stress disorder", J Nerv Ment Dis, 187, pp.680~684 (1999)
