ISSN 2043-8087
Journal of Experimental Psychopathology
 Volume 2, Issue 1, 3-27, 2011
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Substance Use to Regulate Affective Experiences in Posttraumatic Stress Disorder: A Review of Laboratory-Based Studies

Rose C. Smith (a)(b), Matthew T. Feldner (a), Christal L. Badour (a)
(a) University of Arkansas Department of Psychology
(b) Department of Psychiatry, University of Arkansas for Medical Sciences

Volume 2, Issue 1, 2011, Pages 3-27

Posttraumatic stress disorder (PTSD) and elevated levels of substance use (SU) regularly co-occur and are increasingly viewed as functionally related. While PTSD and SU may be comorbid for a variety of reasons, central theoretical work posits that individuals with PTSD use substances to regulate affective experiences. In particular, two theories of psychopathology and SU comorbidity - the Self Medication Hypothesis and the Negative Reinforcement Model - make distinct predictions about the role of SU in regulating affective or emotional experiences. Laboratory methods employed to study PTSD and SU are well suited to test these unique predictions by using in vivo, experimental paradigms. The current review delineates the distinct predications made by these models and reviews the common methods used to study PTSD-SU comorbidity in the laboratory. Studies that have employed these methods are then reviewed and discussed in relation to theoretical predictions. Evidence supports facets of both the Self Medication Hypothesis and the Negative Reinforcement Model, suggesting a complex relation between PTSD and SU, which may be influenced by the particular substance of use, type of affective experience, and related factors such as substance-related withdrawal and risk taking propensity.

Table of Contents
The Current Review
  Study selection criteria
Laboratory Methods for Studying PTSD-SU Comorbidity
  Experimental psychopathology
  Specific Paradigms used for studying PTSD-SU comorbidity
Laboratory Investigations of PTSD-SU Comorbidity
Integrative Discussion and Future Directions
  Substance specificity
  Affective specificity
  Withdrawal and incentive value
General Future Directions

Correspondence to
Rose C. Smith, University of Arkansas for Medical Sciences, Department of Psychiatry, 4301 W. Markham, #553, Little Rock, AR 72205

PTSD, trauma, substance use disorder, comorbidity, experimental psychopathology

Received 5 Jul 2010; Revised 8 Nov 2010; Accepted 15 Nov 2010; In Press 31 Jan 2011

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