Examining the Role of Negative Emotional States on Sedative Drug Use in Individuals With Post-Traumatic Stress Disorder
Condition: Stress Disorders, Post-Traumatic
MeSH terms: Stress Disorders, Traumatic; Stress Disorders, Post-Traumatic
Study type: Observational

Summary: 
      Post-traumatic stress disorder (PTSD) is a serious illness, in which individuals often
      experience anxiety and stress. Some individuals with PTSD use drugs to alleviate emotional
      distress. This study will examine the role that negative emotional states play in sedative
      drug use among individuals with PTSD.
    

Detailed description: 
      PTSD is a psychiatric illness that occurs following a traumatic event in which there was
      threat of injury or death to an individual. Common symptoms of PTSD include anxiety, stress,
      and tension. Some individuals with PTSD use benzodiazepines, a type of sedative medication,
      or alcohol to alleviate the anxiety associated with the disorder. Past research has shown
      that the negative feelings experienced by individuals with PTSD may increase the reinforcing
      effects of antidepressant drugs. Feelings of anxiety act as a stimulus, which leads to drug
      use; in turn, the anticipated or actual decrease in distress reinforces the drug-taking
      behavior. Greater amounts of sedative drugs are then needed to decrease subsequent stress and
      anxiety. The purpose of this study is to understand how negative emotional states affect the
      reinforcing effects of sedative drugs in individuals with PTSD.

      This study will enroll two types of individuals, both of whom have been exposed to an
      emotional trauma and report using alcohol to reduce emotional distress but who differ in
      their subsequent development of PTSD. Participants will take part in an initial screening
      session which will include a physical examination, standardized psychological questionnaires,
      and review of medical and drug histories. Once enrolled, each participant will take part in 8
      experimental session days, with each day of testing separated by at least 48 hours. At the
      beginning of each session, a breathalyzer and urine test will be used to screen for the
      presence of alcohol and drugs. On Day 1, participants will take part in an orientation
      session to familiarize themselves with the laboratory and study procedures. On Days 2 through
      4, participants will receive varying doses of alcohol, a placebo drink, a placebo drug, and
      alprazolam, a type of benzodiazepine medication. On Days 5 through 8, participants will take
      part in experimental challenges designed to induce various emotional states, including
      arousal, anxiety, aggression, and anger. They will also complete a monetary reward task to
      measure the reinforcing effects of drugs. Participants will complete questionnaires several
      times each day to assess anxiety, anger, drug effects, and drug cravings. Heart rate will be
      monitored with an electrocardiogram, and electrodes placed on the skin will measure other
      physiologic measures throughout each session. Participants will receive compensation for
      completing each experimental session.
    

Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        PTSD subjects and subjects who have experienced a trauma but never developed PTSD (Trauma
        Controls) are being recruited for this study. Recruitment is being conducted through Audie
        L. Murphy Veterans Administration Hospital and the University of Texas Health Science
        Center at San Antonio.
      
Keywords: Post-Traumatic Stress Disorders; PTSD