Coping with the effects of exposure to trauma : exploring the link between posttraumatic stress symptoms and problematic substance use in adolescents
Year: 2002
Type: dissertation
Study design: Observational Study
Abstract: To replicate the finding of an association between PTSD symptomatology and problematic drug/ alcohol use in a clinical sample of young people in Scotland.To examine possible gender differences in this association, as well as the potential moderating effects of perceived social support and coping. To test the self-medication hypothesis (SMH).The present study is cross-sectional in design A series of five self-report questionnaires were administered, individually, to obtain measures of PTSD symptomatology, levels of problematic drug and alcohol use, perceived social support and coping.In addition, a short series of structured interview questions were asked, where appropriate, to elicit further information pertaining to drug and/ or alcohol use.The results indicated a lack of a significant association between PTSD and substance use in the sample being studied.Some support for the SMH was obtained with the finding of an association between perceived relatedness of alcohol use and trauma effects, and levels of problemati.c alcohol use.Reported onset of alcohol use prior to the trauma experience was associated with higher levels of problematic use and individuals reporting prior onset of substance use, tended to report an increase in use following the trauma.Conclusions: Results are discussed in the context of prior findings in the literature of a consistent relationship between PTSD and substance use, and methodological limitations of the present study are highlighted.It is suggested, with reservation, that the results provide some support for the SMH.Clinical implications and future recommendations are discussed. 2.2.2Comorbid PTSD and Substance Use Disorders in War Veterans Co-morbidity rates for PTSD and SUDs have been reported by a number of researchers.Keane et al. (1988), for example, carried out a study involving 25 treatment seeking Vietnam War veterans who met DSM-ID criteria for PTSD.They found that 80 percent of this sample had self-reported drug and/ or alcohol problems, while 24 percent met diagnostic criteria for substance abuse or dependence, and 28 percent met criteria for alcohol abuse or dependence.Nace (1988) also reports fairly high levels of alcohol abuse amongst individuals with war related PTSD, with prevalence rates being documented as above 50 percent and, according to Ruzek et al. (1998), the literature documents lifetime rates of comorbid PTSD/alcoholism ranging from 47 to 77 percent, in veterans seeking treatment for PTSD.Lifetime rates of drug abuse are reportedly slightly lower (25-54 percent).Research has not been limited to treatment seeking veterans but has also been carried out with non-treatment seeking veterans.Kulka et al (1990), for example, in the National Vietnam Veterans Readjustment Study, reported that 74 percent of male veterans and 29 percent of female veterans who met DSM-ill-R criteria for PTSD also met criteria for a SUD.Whilst these early studies involved mainly male sufferers (although Jordan et al. 1991, andKulka et al. 1990, did find that an association between PTSD and problematic drug or alcohol use was evident in female as well as male veterans), later studies were carried out with clinical populations of both male and female substance abusers, who had experienced a wide variety of trauma-types as opposed to war-related trauma only. Clinical StudiesResearch has been carried out both with samples of individuals with PTSD, as well as samples of individuals with SUD's and, in both cases, relatively high rates of co-occurring PTSD and problematic substance use have been documented.
Source: ERA
Author: Elaine B. Sinclair
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W2796440779