The influence of posttraumatic stress disorder and recurrent major depression on risk-taking propensity following trauma script exposure among patients with substance use disorders. (March 2020)

• Record Type: Journal Article
• Authors: Vidaña, Ariana G.; Forbes, Courtney N.; Gratz, Kim L.; Tull, Matthew T.
• Is Part Of: Addictive behaviors. Volume 102(2020)
• Publication Date: 2020-03
• Subjects: Depressive disorders -- Impulsivity -- PTSD -- Substance abuse -- Trauma; Substance abuse -- Periodicals; Alcoholism -- Periodicals; Drug addiction -- Periodicals; Nicotine addiction -- Periodicals; Smoking -- Periodicals; Gambling -- Psychological aspects -- Periodicals; Electronic journals; 362.29
• DOI: 10.1016/j.addbeh.2019.106181
• Languages: English
• ISSNs: 0306-4603

Abstract

Highlights: The co-occurrence of PTSD and SUDs is associated with greater risk-taking behavior. Recurrent major depression (MDD) may moderate this association. Risk-taking assessed after a neutral and trauma script. PTSD-MDD associated with lower risk-taking post-trauma script than PTSD alone. PTSD-MDD had lesser risk-taking from neutral to trauma script than PTSD alone. Assessing MDD may identify PTSD patients at greater/lesser risk for risky behaviors. Abstract: Although evidence suggests that risk-taking among individuals with co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) may be precipitated by trauma-related emotional distress, studies have yet to examine moderators of this effect. One moderator worth investigating is recurrent major depressive disorder (MDD), given its influence on emotional responding and subsequent behavior. This study examined the moderating role of recurrent MDD in the relation of PTSD to risk-taking propensity following neutral and trauma scripts among SUD patients. Participants were 193 patients with and without current PTSD and/or recurrent MDD in residential SUD treatment. Risk-taking propensity, as assessed through the Balloon Analogue Risk Task (BART), was evaluated following a neutral script and a personalized trauma script. A significant script by PTSD by recurrent MDD interaction was found. Participants with PTSD and recurrent MDD exhibited significantly lower risk-taking following the trauma script relative to participants with PTSD but no recurrent MDD. Moreover, participants with PTSD and recurrent MDD exhibited a significantly smaller increase in risk-taking following the trauma script (relative to the neutral script) than participants with PTSD but no recurrent MDD. Participants with PTSD and recurrent MDD did not differ significantly from participants without PTSD. Results provide support for the context-dependent nature of risk-taking among PTSD-SUD patients without (vs. with) recurrent MDD. Results also highlight the importance of considering the presence of recurrent MDD in research and/or clinical work with SUD patients with PTSD.