title: Associations between lifetime PTSD symptoms and current substance use disorders using a five-factor model of PTSD.
abstract: This paper aimed to extend the existing knowledge on the association between PTSD symptoms, alcohol use disorders (AUD) and nicotine dependence (ND) by distinguishing between anxious and dysphoric arousal PTSD symptoms and by considering the putative contribution of additional comorbidity. Data stem from a cross-sectional study in a stratified, representative sample of 1483 recently deployed soldiers using standardized diagnostic interviews. All lifetime PTSD symptom clusters (occurrence of any symptom and number of symptoms) were associated with current AUD and ND in crude models except that anxious arousal was not related to AUD. Associations were reduced in magnitude when controlling for comorbidity. Current ND was related to the occurrence of any emotional numbing and to the number of re-experiencing symptoms above the contribution of other symptom clusters and comorbidity. In conclusion, associations between PTSD symptoms, AUD and ND may be partially attributable to additional comorbidity. Findings also yield further evidence for a role of emotional numbing and re-experiencing symptoms in the comorbidity between PTSD and ND and for a distinction between dysphoric and anxious arousal PTSD symptoms.
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany. Electronic address: trautmann@psychologie.tu-dresden.de.
authors.forename: S
authors.initials: S
authors.lastname: Trautmann
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Schönfeld
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Behrendt
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Schäfer
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Höfler
authors.affiliation: Centre for Psychiatry and Posttraumatic Stress, Federal Armed Forces Hospital Berlin, Berlin, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Zimmermann
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
authors.forename: H-U
authors.initials: HU
authors.lastname: Wittchen
mesh_terms: D000328:Adult; D001143:Arousal / Q000502:physiology; D003430:Cross-Sectional Studies; D017831:Diagnosis, Dual (Psychiatry); D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D019966:Substance-Related Disorders / Q000523:psychology*
keywords: Alcohol use disorders; Hyperarousal; Military; Nicotine dependence; Numbing; PTSD; Symptom cluster