Post-trauma anhedonia is associated with increased substance use in a recently-traumatized population

• Authors: Negar Fani, Emory University; Jahnvi Jain, Emory University; Lauren Hudak, Emory University; Barbara Rothbaum, Emory University; Kerry Ressler, Emory University; Vasiliki Michopoulos, Emory University
• Journal Title: PSYCHIATRY RESEARCH
• Volume: Volume 285
• Publisher: ELSEVIER IRELAND LTD | 2020-03-01, Pages 112777-112777
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1016/j.psychres.2020.112777
• Subjects: Health Sciences, Medicine and Surgery; Health Sciences, Mental Health
• Keywords: Science & Technology; Life Sciences & Biomedicine; Psychiatry; Anhedonia; Substance use; Trauma; PTSD; Emergency department; STRESS-DISORDER SYMPTOMS; C-REACTIVE PROTEIN; CANNABIS USE; FUNCTIONAL CONNECTIVITY; HEDONIC CAPACITY; COMBAT VETERANS; DRUG; DEPRESSION; SMOKING

Abstract

Recreational substance use (SU) can emerge or worsen in the aftermath of psychological trauma. Anhedonia is one reason for this problematic SU. Symptoms of posttraumatic stress disorder (PTSD) that represent anhedonia (post-trauma anhedonia; PTA) have been consistently linked to SU disorders. However, no prospective studies have examined whether changes in PTA over time are associated with problematic SU in recently-traumatized people, which was the goal of this study. 165 men and women were recruited as part of a prospective PTSD study in the emergency department of a Level 1 trauma center. Clinical assessments of PTSD and SU were administered at three and six months post-trauma. Compared to participants with minimal SU at six months post-trauma, high substance users at six months post-trauma showed significant increases in PTA during the three to six month time period. This relationship was significant even after accounting for variance associated with other factors, including PTSD symptoms such as re-experiencing and hyperarousal. Participants who demonstrated increases in SU during this time also showed significant increases in PTA, unlike those who demonstrated consistently minimal/no SU during this time. These findings indicate that PTA may be a mechanism through which SU problems emerge in recently-traumatized individuals.