Neural and Behavioral Correlates of PTSD and Alcohol Use.

摘要

Hazardous use of alcohol negatively impacts the treatment of PTSD. However, the mechanisms that underlie the association between PTSD and hazardous alcohol use in veterans are poorly understood. The current research takes a multi-level approach to study the psychological, behavioral, cognitive and neural relationships between PTSD and alcohol use in OEF/OIF veterans. Participants with PTSD showed greater difficulty in suppressing emotional content in favor of a cognitive output when presented with combat-associated stimuli, an effect mediated by the anterior cingulate cortex. PTSD was associated with heightened anterior cingulate activity during an emotional interference task, and comorbidity of PTSD with hazardous alcohol use resulted in more expansive recruitment of frontal regions involved in executive function when required to suppress emotional information. The findings from detailed analysis of contributing influences suggest that targeting the factors underlying the relationship between PTSD and hazardous alcohol use (affect liability, behavioral disinhibition, anterior cingulate activity) or recognizing factors that mediate effects on emotional expression and suppression and underlying brain regions (predeployment drinking, combat exposure intensity) may represent important treatment strategies for PTSD and hazardous alcohol use in recently returned combat veterans.