مقایسه ولع مصرف در افراد وابسته به الکل مبتلا و غیر مبتلا به اختلال استرس پس از سانحه در دوره پرهیز از مصرف

نوع مقاله: مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری، گروه روان‌شناسی بالینی، دانشکده علوم انسانی، دانشگاه علم و فرهنگ، تهران، ایران

2 کارشناس ارشد، گروه مشاوره مدرسه، دانشگاه علامه طباطبایی، تهران، ایران.

3 کارشناس ارشد، گروه روان‌شناسی، دانشگاه آزاد اسلامی واحد زنجان، زنجان، ایران.

4 دانشجوی کارشناسی ارشد، گروه روان‌شناسی شخصیت، دانشگاه آزاد اسلامی واحد علوم و تحقیقات، تهران، ایران.

چکیده

مقدمه: از دیدگاه سبب­شناسی یکی از موضوعات بالینی که سبب دشواری درمان اختلال استرس پس از سانحه می­شود، هم زمانی تشخیص این اختلال با اختلال سوءمصرف الکل می­باشد. افزایش فعالیت نورآدرنرژیک فصل مشترک هر دو اختلال است. پژوهش حاضر با هدف مقایسه ولع مصرف در افراد وابسته به الکل مبتلا و غیر مبتلا به اختلال استرس پس از سانحه در دوره پرهیز از مصرف انجام شد.
مواد و روش­ ها: مطالعه­ حاضر، پژوهشی توصیفی است. از جامعه مردان وابسته به الکل، 80 آزمودنی به روش داوطلبانه انتخاب و به واسطه آزمون غربالگری افرادی که بالاترین و پائین­ترین نمرات را با توجه به نقطه برش مفروض در آزمون استرس پس از سانحه کسب نمودند گزینش شدند. سپس نمونه مذکور جهت مقایسه در قالب دو گروه دارا و فاقد نشانگان تخصیص یافتند. پرسشنامه ولع مصرف توسط آنان تکمیل شد. داده­های جمع­آوری شده به کمک آزمون­های مجذورکای، تی مستقل و همبستگی پیرسون تحلیل شدند.
یافته­ ها: میانگین و انحراف معیار (با فاصله اطمینان 95/0) متغیر ولع مصرف در گروه اختلال استرس پس از سانحه
58/2 ± 72/11 و در گروه کنترل 24/2 ± 73/9 بود (01/0>p). بین میزان شدت نشانگان اختلال استرس پس از سانحه و ولع مصرف الکل ارتباط معنی­داری مشاهده شد (001>p).
 نتیجه­ گیری: یافته­ های این پژوهش لزوم توجه به اهمیت همبودی دو اختلال و نقش این همبودی در طرح­ریزی مداخلات پیشگیرانه و درمانی در حیطه اعتیاد را منعکس می­سازد.

کلیدواژه‌ها


عنوان مقاله [English]

A Comparison of Craving in Alcohol-Dependent Individuals with and without the Post-Traumatic Stress Disorder at the Phase of Usage Abstinence

نویسندگان [English]

  • B Pirnia 1
  • M Eslami 2
  • M Bazargan 3
  • P Sadeghi 4
1 PhD Student, Dept of Psychology, Faculty of Humanities, University of Science and Culture, Tehran, Iran.
2 Msc, Dept of School Counseling, Allameh Tabataba'i University, Tehran, Iran.
3 Msc, Dept of Psychology, Islamic Azad University, Zanjan Branch, Zanjan, Iran.
4 Msc Student, Dept of Personality Psychology, Islamic Azad University, Science and Research Brach, Tehran, Iran.
چکیده [English]

Introduction: In terms of etiology, one of the clinical topics which makes it difficult to treat the post-traumatic stress disorder is co-alcohol abuse. Increased noradrenergic activity is the intersection of both disorders. The present study was conducted with the aim of examining the relationship between posttraumatic stress disorder and alcohol usage craving index.
Materials and Methods: The present study was cross-sectional. There were two alcohol-dependent groups: in one group the participants had posttraumatic stress disorder symptoms, and in the other group the participants lacked posttraumatic stress disorder. Among the men who referred to Alcohol Anonymous Groups in Tehran, 80 participants that obtained the highest and the lowest scores based on the cut-off point of the posttraumatic stress disorder test were selected and assigned to the two groups of with and without posttraumatic stress disorder symptoms for comparison. Posttraumatic Stress Disorder Questionnaire and Usage Craving Questionnaire were completed by the participants. The collected data were analyzed using Chi-Square, independent t-test and Pierson correlation tests.
Results: The results showed that the mean [95% confidence interval (CI)] scores of craving in PTSD group was 11.72 (2.58) and in the control group it was 9.73 (2.24) with control (all P< 0.01). Also, a significant relationship was seen between the severity of posttraumatic stress disorder and alcohol usage craving (p<0.01).
Conclusion: The findings of the present study reflect the necessity of paying attention to the comorbidity of these two disorders and the role of this comorbidity in planning preventing and therapeutic interventions in the field of addiction.

کلیدواژه‌ها [English]

  • Posttraumatic Stress Disorder (PTSD)
  • craving
  • Alcohol Use Disorder (AUD)
  1. Blanco C, Xu Y, Brady K, Pérez-Fuentes G, Okuda M, Wang S. Comorbidity of posttraumatic stress disorder with alcohol dependence among US adults: results from National Epidemiological Survey on Alcohol and Related Conditions. Drug and alcohol dependence 2013;132(3):630-8.
  2. Bailey CR, Cordell E, Sobin SM, Neumeister A. Recent progress in understanding the pathophysiology of post-traumatic stress disorder. CNS drugs 2013;27(3):221-32.
  3. Shad MU, Suris AM, North CS. Novel combination strategy to optimize treatment for PTSD. Human Psychopharmacology: Clinical and Experimental 2011;26(1):4-11.
  4. Pietrzak RH, Gallezot J-D, Ding Y-S, Henry S, Potenza MN, Southwick SM, et al. Association of posttraumatic stress disorder with reduced in vivo norepinephrine transporter availability in the locus coeruleus. JAMA psychiatry 2013;70(11):1199-205.
  5. Ouimette P, Read J, Brown PJ. Consistency of retrospective reports of DSM‐IV Criterion A traumatic stressors among substance use disorder patients. Journal of traumatic stress. 2005;18(1):43-51.
  6. Nunes EV, Levin FR. Treatment of depression in patients with alcohol or other drug dependence: a meta-analysis. Jama 2004;291(15):1887-96.
  7. Ekhtiari H, Edalati H, Behzadi A, Safaei H, Noori M, Mokri A. Designing and evaluation of reliability and validity of five visual cue-induced craving tasks for different groups of opiate abusers. Iranian journal of psychiatry and clinical psychology. 2008;14(3):337-49.
  8. Abrams DB. Transdisciplinary concepts and measures of craving: commentary and future directions. Addiction 2000;95(8s2):237-46.
  9. Verheul R, van den Brink W, Geerlings P. A three-pathway psychobiological model of craving for alcohol. Alcohol and alcoholism (Oxford, Oxfordshire) 1999;34(2):197-222.
  10. Garland EL, Boettiger CA, Howard MO. Targeting cognitive-affective risk mechanisms in stress-precipitated alcohol dependence: an integrated, biopsychosocial model of automaticity, allostasis, and addiction. Medical hypotheses 2011;76(5):745-54.
  11. Banna KM, Back SE, Do P, See RE. Yohimbine stress potentiates conditioned cue-induced reinstatement of heroin-seeking in rats. Behavioural brain research 2010;208(1):144-8.
  12. Zaslav MR. Psychology of comorbid posttraumatic stress disorder and substance abuse: Lessons from combat veterans. Journal of psychoactive drugs 1994;26(4):393-400.
  13. Hyman SM, Fox H, Hong K-IA, Doebrick C, Sinha R. Stress and drug-cue-induced craving in opioid-dependent individuals in naltrexone treatment. ECP 2007;15(2):134.
  14. Ford JD, Elhai JD, Connor DF, Frueh BC. Poly-victimization and risk of posttraumatic, depressive, and substance use disorders and involvement in delinquency in a national sample of adolescents. Journal of Adolescent Health 2010;46(6):545-52.
  15. Sullivan T, Cavanaugh C, Buckner J, Edmondson D. Intimate partner violence (IPV) and drug and alcohol use problems among community women: The roles of physical, sexual, and psychological IPV and PTSD. J Trauma Stress 2009;22:575-84.
  16. Read JP, Brown PJ, Kahler CW. Substance use and posttraumatic stress disorders: Symptom interplay and effects on outcome. Addictive Behaviors 2004;29(8):1665-72.
  17. Wiechelt SA, Miller BA, Smyth NJ, Maguin E. Associations between post-traumatic stress disorder symptoms and alcohol and other drug problems: Implications for social work practice. Practice 2011;23(4):183-99.
  18. Pirnia B, Pirnia K. Comparison of Two Mindfulness-Based Cognitive Therapies and Acupuncture on the Pain and Depression Index in a Case with Lobular Carcinoma: A Single Case Experimental Study. IJCM 2018;11(6):e65641.
  19. Sharifi V, Assadi SM, Mohammadi MR, Amini H, Kaviani H, Semnani Y, et al. A persian translation of the structured clinical interview for diagnostic and statistical manual of mental disorders: psychometric properties. Comprehensive psychiatry 2009;50(1):86-91.
  20. Foa EB, Riggs DS, Dancu CV, Rothbaum BO. Reliability and validity of a brief instrument for assessing post‐traumatic stress disorder. Journal of traumatic stress 1993;6(4):459-73.
  21. Franken IH, Hendriks VM, van den Brink W. Initial validation of two opiate craving questionnaires: the Obsessive Compulsive Drug Use Scale and the Desires for Drug Questionnaire. Addictive behaviors 2002;27(5):675-85.
  22. Lievaart M, Erciyes F, van der Veen FM, van de Wetering BJ, Muris P, Franken IH. Validation of the cocaine versions of the Obsessive Compulsive Drug Use Scale and the Desires for Drug Questionnaire. AJDAA 2015;41(4):358-65.
  23. Gorka SM, MacNamara A, Aase DM, Proescher E, Greenstein JE, Walters R, et al. Impact of alcohol use disorder comorbidity on defensive reactivity to errors in veterans with posttraumatic stress disorder. Psychology of addictive behaviors 2016;30(7):733-42.
  24. Erb S. Evaluation of the relationship between anxiety during withdrawal and stress-induced reinstatement of cocaine seeking. PNPBP 2010;34(5):798-807.
  25. Pirnia B, Givi F, Roshan R, Pirnia K, Soleimani AA. The cortisol level and its relationship with depression, stress and anxiety indices in chronic methamphetamine-dependent patients and normal individuals undergoing inguinal hernia surgery. MJIRI 2016;30:395.
  26. Simons JS, Simons RM, O'Brien C, Stoltenberg SF, Keith JA, Hudson JA. PTSD, alcohol dependence, and conduct problems: Distinct pathways via lability and disinhibition. Addictive behaviors 2017;64:185-93.
  27. Staiger PK, Melville F, Hides L, Kambouropoulos N, Lubman DI. Can emotion-focused coping help explain the link between posttraumatic stress disorder severity and triggers for substance use in young adults? Journal of substance abuse treatment 2009;36(2):220-6.
  28. Goeders NE. Stress, Motivation, and Drug Addiction. Current Directions in Psychological Science 2004;13(1):33–5.
  29. Ilgen M, Jain A, Kim HM, Trafton JA. The effect of stress on craving for methadone depends on the timing of last methadone dose. Behaviour research and therapy 2008;46(10):1170-5.
  30. Buffalari DM, See RE. Footshock stress potentiates cue-induced cocaine-seeking in an animal model of relapse. Physiology & behavior 2009;98(5):614-7.
  31. Saladin ME, Brady KT, Dansky BS, Kilpatrick DG. Understanding comorbidity between PTSD and substance use disorders: two preliminary investigations. Addictive behaviors 1995;20(5):643-55.
  32. Lemieux CM, Plummer CA, Richardson R, Simon CE, Ai AL. Mental health, substance use, and adaptive coping among social work students in the aftermath of Hurricanes Katrina and Rita. JSWE 2010;46(3):391-410.
  33. Stewart SH, Pihl RO, Conrod PJ, Dongier M. Functional associations among trauma, PTSD, and substance-related disorders. Addictive behaviors 1998;23(6):797-812.
  34. Ramos Z, Fortuna LR, Porche MV, Wang Y, Shrout PE, Loder S, et al. Posttraumatic stress symptoms and their relationship to drug and alcohol use in an international sample of Latino immigrants. JIMH 2017;19(3):552-61.
  35. Pirnia B, Rezaei M, Mansour S, Soleimani AA, Pirkhaefi A, Soleimani A. Addiction and Psychological Consequences, the Relationship between the Anxiety and Inductive Usage Craving Index in Individuals under the Treatment of Methadone Have and Lack Anxiety Symptoms, a Cross-Sectional Study. SHJPP 2016; 3 (2) :33-43.