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An ecological momentary assessment study examining posttraumatic stress disorder symptoms, prenatal bonding, and substance use among pregnant women.

Abstract：

BACKGROUND:Substance use disorder (SUD) during pregnancy requires efficacious interventions based on understanding the ebb and flow of risk and protective factors for substance use across time. To assess how these fluctuations are associated temporally with substance use, we used ecological momentary assessment (EMA) to evaluate substance use risk (posttraumatic stress disorder [PTSD] symptoms) and protective (prenatal fetal bonding) factors and their associations with prenatal substance use recorded in real time. METHODS:Pregnant women in SUD treatment (N = 33) with prior trauma exposure received smartphones with an EMA application that queried them thrice daily for 28 days about PTSD symptoms, prenatal bonding, and substance use. RESULTS:Nearly all (N = 32) provided EMA data resulting in 2049 EMA reports (74% compliance). Most participants reported tobacco (72%), alcohol (22%), heroin (41%), and/or other illicit drug (6%-31%) use at least once via EMA. There were moderate associations (average β = 0.23) between greater daily peak PTSD symptoms and substance use with significant effects on illicit drug (β = 0.37), cannabis (β = 0.35) and cigarette use (β = 0.24). Prenatal bonding subscales were modestly associated with substance use, with daily intensity of attachment low point associated with lower heroin (β=-0.34), but higher alcohol (β = 0.24) use. Quality of attachment low point was associated with higher cigarette use (β = 0.06). CONCLUSIONS:Despite the SUD severity and social instability of this sample, we observed high rates of compliance. We found preliminary support suggesting daily PTSD symptoms as a risk factor and less consistent support for prenatal bonding as a protective factor for prenatal substance use.

journal_name

Drug Alcohol Depend

journal_title

Drug and alcohol dependence

authors

Sanjuan PM,Pearson MR,Poremba C,Amaro HLA,Leeman L

doi

10.1016/j.drugalcdep.2018.11.019

subject

Has Abstract

pub_date

2019-02-01 00:00:00

pages

33-39

eissn

0376-8716

issn

1879-0046

pii

S0376-8716(18)30829-9

journal_volume

195

pub_type

杂志文章

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An ecological momentary assessment study examining posttraumatic stress disorder symptoms, prenatal bonding, and substance use among pregnant women.