A prospective study of posttraumatic stress symptom development and cannabis use among trauma exposed injured emerging adults following Emergency Department discharge

急诊科出院后遭受创伤的受伤新兴成年人的创伤后应激症状发展和大麻使用的前瞻性研究

• 批准号: 10598073
• 负责人: Leslie Ann Daline Brick
• 金额: $ 40.57万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10598073
• 关键词: Accident and Emergency department; Acute; Adult; Affect; Affective; Anxiety; Arousal; Behavior; Belief; Cannabinoids; Cannabis; Centers of Research Excellence; Chronic; Clinical; Cognition; Collection; Communities; Complex; Consumption; Coupling; Development; Diagnosis; Distress; Ecological momentary assessment; Emergency Department evaluation; Goals; Health; Heart Rate; Hospitals; Individual; Injury; Intensive Care; Interview; Laws; Legal; Licensing; Life; Link; Long-Term Effects; Medical Marijuana; Mental Depression; Modeling; Monitor; Negative Reinforcements; Outcome; Output; Participant; Patient Admission; Patient Self-Report; Pattern; Physiological; Physiology; Play; Post-Traumatic Stress Disorders; Prospective Studies; Psychopathology; Qualifying; Recovery; Reporting; Research; Rhode Island; Risk; Role; Safety; Sampling; Self Medication; Severities; Sleep Disorders; Sleeplessness; Stress; Substance Use Disorder; Symptoms; Therapeutic; Time; Trauma; Trauma patient; Trauma recovery; Traumatic injury; United States; Vehicle crash; Withdrawal Symptom; acute stress; acute symptom; aged; alcohol and other drug; anxiety reduction; anxiety states; biological adaptation to stress; cannabis use behavior; clinically significant; coping; critical period; emerging adult; endogenous cannabinoid system; experience; follow-up; high risk; injured; insight; marijuana legalization; marijuana use; marijuana use disorder; marijuana user; mortality; negative affect; negative mood; patient oriented; physical assault; post-trauma; post-traumatic symptoms; prospective; recruit; reduce symptoms; response; smart watch; social relationships; stress symptom; substance misuse; substance use; symptom cluster; trauma centers; trauma exposure; trauma symptom; wearable sensor technology

PROJECT SUMMARY Individuals who experience traumatic physical injury are at a heightened risk for a range of negative outcomes such as posttraumatic stress disorder (PTSD) and substance misuse. The early post-trauma period (i.e., the days, weeks, and months following exposure) represents a critical period of recovery and may be especially important for understanding symptom development among emerging adults (aged 18-25), who are characterized by a developmental peak in substance use behaviors and an increased risk for trauma exposure and injury. As regional laws, cultures, and beliefs about cannabis use (CU) continue to shift, there is concern that traumatic injury may result in escalations in cannabis use, as many individuals report using cannabis to relieve distress, hyperarousal, and other post-trauma symptoms. Furthermore, while the majority of US states that have legalized cannabis for medical use include outcomes of stress and trauma (such as PTSD) as qualifying conditions for a state-issued medical marijuana license, little is known about how CU may impact the early post-trauma course, including development of PTSD and other stress-related outcomes such as depression, anxiety, and substance misuse. Despite the known role of the endocannabinoid system in regulating the stress response, limited (and contradicting) evidence exists regarding safety and efficacy of cannabis precludes strong conclusions about its role during acute post-trauma recovery, with some prospective studies demonstrating detrimental or no long-term effects of CU on PTSD symptoms. The overarching goals of the proposed study are to characterize CU as related to post-trauma symptoms and cannabis misuse during the period immediately following trauma exposure among a sample of injured emerging adults. We will recruit N=100 trauma-exposed cannabis users (aged 18-25) presenting to the Emergency Department for evaluation after acute injury (e.g., physical assault, serious vehicular crashes). Upon discharge, participants will complete 4-weeks of ecological momentary assessment (EMA) to record CU behavior and PTSD symptom development, paired with passive collection of physiological output (heart rate) via wearable biosensors (smartwatch) to monitor physiology. Participants will return for completion of clinical interview and self-report of symptoms at 4-weeks and 6-months post-discharge. The main objectives of this research are to: (a) characterize the course of PTSD symptom development, physiology, and cannabis use during the acute post-trauma period and (b) evaluate effects of the acute post-trauma response on long term development of PTSD and other stress sensitive outcomes (depression, anxiety, cannabis misuse) at 6-month follow-up.

项目摘要 遭受创伤性身体伤害的个人面临着一系列负面结果的风险 例如创伤后应激障碍（PTSD）和药物滥用。创伤后早期（即 接触后的几天，几周和几个月）代表一个关键的恢复时期，尤其是 对于了解新兴成年人的症状发展（18-25岁）的重要重要 以物质使用行为的发展峰值和创伤风险增加的特征 和受伤。随着区域法律，文化和对大麻使用（CU）的信念继续转移，人们关注 这种创伤性伤害可能导致大麻使用的升级，因为许多人报告使用大麻 缓解痛苦，高音和其他创伤后症状。此外，尽管我们大多数人说 将大麻合法化的医疗用途的大麻包括压力和创伤的结果（例如PTSD） 国家签发的医用大麻许可证的合格条件，关于CU可能如何影响CU 创伤后课程早期，包括开发PTSD和其他与压力有关的结果，例如 抑郁，焦虑和药物滥用。尽管内源性大麻素系统在 规范压力反应，有限（和矛盾的）证据，存在有关安全性和有效性的证据 大麻无法就其在急性创伤后恢复中的作用得出强烈的结论，其中一些 前瞻性研究表明CU对PTSD症状的有害或没有长期影响。这 拟议的研究的总体目标是将CU表征与创伤后症状和 在受伤的样本中，在创伤暴露后立即滥用大麻 新兴的成年人。我们将招募n = 100个受创伤的大麻使用者（18-25岁） 急诊室急性受伤后（例如，身体攻击，严重的车辆撞车事故）。 出院后，参与者将完成4周的生态瞬时评估（EMA）以记录Cu 行为和PTSD症状发展，与被动收集生理输出（心率）配对 通过可穿戴生物传感器（智能手表）监测生理学。参与者将返回完成临床 在四个月和晚期出院后6个月的症状访谈和自我报告。这个的主要目标 研究是：（a）表征PTSD症状发展，生理和大麻使用的过程 在急性创伤后时期，（b）长期评估急性创伤后反应的影响 在6个月的时间 后续。