PTSD Symptom Clusters and Craving Differs by Primary Drug of Choice

Somohano, Vanessa C.; Rehder, Kristoffer; Dingle, Tyree; Shank, Taylor; Bowen, Sarah

doi:10.1080/15504263.2019.1637039

Cited by 19 publications

(7 citation statements)

References 75 publications

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“…impulsivity and stress reactivity, rather than particular disorders (e.g. personality disorders and PTSD), and the associated symptoms may differ across substances (Joos et al, 2013; Simpson, Stappenbeck, Varra, Moore, & Kaysen, 2012; Somohano, Rehder, Dingle, Shank, & Bowen, 2019; Yoon et al, 2021). Additional studies should explore the relationship of craving to psychiatric disorders and symptoms and the directionality of these relationships.…”

Section: Discussionmentioning

confidence: 99%

Validity of the DSM-5 craving criterion for alcohol, tobacco, cannabis, cocaine, heroin, and non-prescription use of prescription painkillers (opioids)

Shmulewitz

Stohl²,

Greenstein³

et al. 2021

Psychol. Med.

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Background Although the DSM-5 was adopted in 2013, the validity of the new substance use disorder (SUD) diagnosis and craving criterion has not been investigated systematically across substances. Methods Adults (N = 588) who engaged in binge drinking or illicit drug use and endorsed at least one DSM-5 SUD criterion were included. DSM-5 SUD criteria were assessed for alcohol, tobacco, cannabis, cocaine, heroin, and opioids. Craving was considered positive if “wanted to use so badly that could not think of anything else” (severe craving) or “felt a very strong desire or urge to use” (moderate craving) was endorsed. Baseline information on substance-related variables and psychopathology was collected, and electronic daily assessment queried substance use for the following 90 days. For each substance, logistic regression estimated the association between craving and validators, i.e. variables expected to be related to craving/SUD, and whether association with the validators differed for DSM-5 SUD diagnosed with craving as a criterion v. without. Results Across substances, craving was associated with most baseline validators (p values<0.05); neither moderate nor severe craving consistently showed greater associations. Baseline craving predicted subsequent use [odds ratios (OR): 4.2 (alcohol) – 234.3 (heroin); p's ⩽ 0.0001], with stronger associations for moderate than severe craving (p's < 0.05). Baseline DSM-5 SUD showed stronger associations with subsequent use when diagnosed with craving than without (p's < 0.05). Conclusion The DSM-5 craving criterion as operationalized in this study is valid. Including craving improves the validity of DSM-5 SUD diagnoses, and clinical relevance, since craving may cause impaired control over use and development and maintenance of SUD.

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Section: Discussionmentioning

confidence: 99%

Validity of the DSM-5 craving criterion for alcohol, tobacco, cannabis, cocaine, heroin, and non-prescription use of prescription painkillers (opioids)

Shmulewitz

Stohl²,

Greenstein³

et al. 2021

Psychol. Med.

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“…In total, 3580 subjects were enrolled, of which 1960 (54.7%) met criteria for PTSD and SUD, 1206 (33.7%) for SUD only, and 105 for PTSD only. One study ( 37 ) did not indicate the prevalence of low vs. high PTSD scores. Participants were most often males (65.6%), with a mean age of 41.3 years.…”

Section: Resultsmentioning

confidence: 99%

“…Participants with PTSD had a higher addiction severity score, were more often hospitalized, had a shorter abstinence time between relapses and experienced craving more frequently than other participants. Somohano et al ( 37 ) assessed the correlation between severity of different symptoms of PTSD and craving according to four classes of substances: alcohol, psycho-stimulants (cocaine, amphetamines), opiates and cannabis. Concerning subjects with alcohol use disorder ( n = 131), global PTSD severity and hypervigilance levels were associated with craving intensity.…”

Section: Resultsmentioning

confidence: 99%

The Impact of Co-occurring Post-traumatic Stress Disorder and Substance Use Disorders on Craving: A Systematic Review of the Literature

et al. 2021

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The frequent co-occurrence of post-traumatic stress disorder (PTSD) and substance use disorders (SUDs) leads to manifestations of both conditions that are more severe and more resistance to treatment than single disorders. One hypothesis to explain this synergy is the impact of intrusive memories on craving which, in turn, increases the risk of relapse among patients with substance use disorders. The aim of this systematic review is to examine this possibility by assessing the impact of PTSD and its symptoms on craving among dual disorder patients. Using PRISMA criteria, four databases were comprehensively searched up to June, 2021, in order to identify all candidate studies based on broad key words. Resulting studies were then selected if they examined the impact of PTSD or PTSD symptoms on craving, and if they used standardized assessments of PTSD, SUD, and craving. Twenty-seven articles matched the selection criteria and were included in this review. PTSD was found to be significantly associated with increased craving levels among patients with alcohol, cannabis, cocaine, tobacco, and other substance use disorders. Exposition to traumatic cues among dual disorder patients was also shown to trigger craving, with an additive effect on craving intensity when exposure to substance-related cues occurred. In addition, certain studies observed a correlation between PTSD symptom severity and craving intensity. Concerning mechanisms underlying these associations, some findings suggest that negative emotional states or emotion dysregulation may play a role in eliciting craving after traumatic exposure. Moreover, these studies suggest that PTSD symptoms may, independently of emotions, act as powerful cues that trigger craving. These findings argue for the need of dual disorder treatment programs that integrate PTSD-focused approaches and emotion regulation strategies, in addition to more traditional interventions for craving management.

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“…Generell stellte sich ein signifikanter Zusammenhang zwischen dem Gesamt-Score über alle PTBS-Symptomcluster und der Intensität des berichteten Cravings für die untersuchten Substanzen (Alkohol, Stimulantien, Opiate) dar. Es zeichneten sich bei bevorzugt eingesetzten Substanzen („drug of choice“ ) einige typische Assoziationen zu speziellen PTBS-Symptomclustern ab (Stimulantien: PTBS-Vermeidung; Alkohol: PTBS-Hyperarousal; Opiate: kein spezielles PTBS-Symptommuster [ 179 ]).…”

Section: Trauma/ptbs Als Risikofaktor Für Substanzkonsumstörung – Sel...unclassified

Zur Komorbidität von Posttraumatischer Belastungsstörung und Sucht in biopsychosozialer Perspektive

Kapfhammer

2021

Neuropsychiatr

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ZusammenfassungPosttraumatische Belastungsstörung und Substanzkonsumstörungen treten im medizinischen Versorgungssystem häufig koexistent auf. Ihre Komorbidität geht mit schwerwiegenderen akuten klinischen Symptombildern, mit zahlreichen, oft notfallmäßigen Hospitalisierungen und geringeren Behandlungserfolgen einher. Ihre Komorbidität trägt zu dramatisch ungünstigeren Verläufen auf allen biopsychosozialen Ebenen bei. Das Thema Komorbidität von PTBS und Sucht wird auf mehreren Ebenen untersucht: in den Perspektiven von Epidemiologie, Substanzkonsumstörung als Risikofaktor für Trauma und PTBS, Trauma und PTBS als Risikofaktor für Substanzkonsumstörung, neurobiologischen Konsequenzen einer Substanzkonsumstörung für die Neurobiologie von PTBS, gemeinsam geteilten Faktoren der Genetik/Epigenetik, Persönlichkeitsdimensionen und aversiven/traumatogenen Einflüssen in der frühen Entwicklung. Der Hauptfokus der Analyse liegt auf den wechselseitig sich verstärkenden Mechanismen, die der Entwicklung und dem Verlauf beider Störungsbilder inhärent sind.

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PTSD Symptom Clusters and Craving Differs by Primary Drug of Choice

Cited by 19 publications

References 75 publications

Validity of the DSM-5 craving criterion for alcohol, tobacco, cannabis, cocaine, heroin, and non-prescription use of prescription painkillers (opioids)

Validity of the DSM-5 craving criterion for alcohol, tobacco, cannabis, cocaine, heroin, and non-prescription use of prescription painkillers (opioids)

The Impact of Co-occurring Post-traumatic Stress Disorder and Substance Use Disorders on Craving: A Systematic Review of the Literature

Zur Komorbidität von Posttraumatischer Belastungsstörung und Sucht in biopsychosozialer Perspektive

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