Childhood Abuse as a Factor in Attrition from Drug Rehabilitation

Palmer, Jack A.; Palmer, Linda K.; Williamson, David J.; Michiels, Krista; Thigpen, Brian

doi:10.2466/pr0.1995.76.3.879

Cited by 30 publications

(6 citation statements)

References 6 publications

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“…This is a self-selected group that may be quite different from those who choose not to participate or from early treatment dropouts who were excluded for practical reasons. For example, dropping out early due to relapse seems to be associated with abuse histories [2]. Nevertheless, even if there are differences in abuse rates between participants and nonparticipants, this may well be of no consequence for the internal validity of the results.…”

Section: Discussionmentioning

confidence: 99%

“…The family/social domain includes two items assessing lifetime physical and sexual assault, reflecting the notion that the systematic inquiry about abusive histories is clinically relevant. These experiences may play an important role in the etiology of a number of psychiatric disorders as well as in relapse potential of substance abusers [2]. Given the wide use of the ASI for clinical purposes, information on the utility of the abuse questions is of great importance.…”

Section: Introductionmentioning

confidence: 99%

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Sensitivity of the Addiction Severity Index Physical and Sexual Assault Items: Preliminary Findings on Gender Differences

Langeland

Brink²,

Draijer³

et al. 2001

Eur Addict Res

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Objective: Evaluation of the Addiction Severity Index (ASI) as a screen for identifying sexual and physical assault histories. Method: The sensitivity and specificity of the ASI assault items were examined in 146 alcoholic patients with the assault questions of the Composite International Diagnostic Interview posttraumatic stress module as external criterion. Results: The sensitivity of the ASI items was lower than their specificity for both physical (sensitivity = 0.35, specificity = 0.83) and sexual abuse (sensitivity = 0.69, specificity = 0.94). These findings indicate an underestimation of such abuse histories in male patients due to screening for a narrow range of possible perpetrators. Conclusion: The ASI method as a screen for sexual and physical assault histories could be improved, considering that men clearly outnumber women in persons applying for alcohol treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sensitivity of the Addiction Severity Index Physical and Sexual Assault Items: Preliminary Findings on Gender Differences

Langeland

Brink²,

Draijer³

et al. 2001

Eur Addict Res

View full text Add to dashboard Cite

show abstract

“…Likewise civilians with a PTSD and substance use disorder comorbidity reported more relapses or unfavorable treatment results [ 31 , 86 ]. Individuals reporting more traumatic experiences dropped out of inpatient detoxification treatment more readily [ 87 , 88 ]. All these findings have been interpreted such that traumatized individuals depend more on consumption in order to self-medicate trauma-related negative emotional, physical and cognitive states than non-traumatized patients.…”

Section: Discussionmentioning

confidence: 99%

Drinking to ease the burden: a cross-sectional study on trauma, alcohol abuse and psychopathology in a post-conflict context

et al. 2016

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BackgroundIt is likely that alcohol use and abuse increase during and after violent conflicts. The most prominent explanation of this phenomenon has been referred to as self-medication hypothesis. It predicts that psychotropic substances are consumed to deal with conflict-related psychic strains and trauma. In northern Uganda, a region that has been affected by a devastating civil war and is characterized by high levels of alcohol abuse we examined the associations between war-trauma, childhood maltreatment and problems related to alcohol use. Deducing from the self-medication hypothesis we assumed alcohol consumption moderates the relationship between trauma-exposure and psychopathology.MethodsA cross-sectional epidemiological survey targeting war-affected families in post-conflict northern Uganda included data of male (n = 304) and female (n = 365) guardians. We used standardized questionnaires in an interview format to collect data on the guardians’ socio-demography, trauma-exposure, alcohol consumption and symptoms of alcohol abuse, PTSD and depression.ResultsSymptoms of current alcohol use disorders were present in 46 % of the male and 1 % of the female respondents. A multiple regression model revealed the unique contributions of emotional abuse in the families of origin and trauma experienced outside the family-context in the prediction of men’s alcohol-related symptoms. We found that alcohol consumption moderated the dose-effect relationship between trauma-exposure and symptoms of depression and PTSD. Significant interactions indicated that men who reported more alcohol-related problems experienced less increase in symptoms of PTSD and depression with increasing trauma-exposure.ConclusionsThe gradual attenuation of the dose-effect the more alcohol-related problems were reported is consistent with the self-medication hypothesis. Hence, the functionality of alcohol consumption has to be considered when designing and implementing addiction treatment in post-conflict contexts.

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“…Research has demonstrated a strong positive association between ACEs and substance use disorders [ 11 – 14 ]. There is also evidence that presence of ACEs has a negative influence on management of patients with substance use disorders [ 15 – 17 ]. This indicates the need for screening of ACEs so that prevention measures could be put in place after identification of those at risk.…”

Section: Introductionmentioning

confidence: 99%

Adverse childhood experiences among patients with substance use disorders at a referral psychiatric hospital in Kenya

et al. 2018

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BackgroundSubstance use disorders are a major cause of health and social problems worldwide. Research evidence shows a strong graded relationship of adverse childhood experiences and substance use in adulthood. This study aimed at determining the prevalence of adverse childhood experiences and their association with substance use among patients with substance use disorders.MethodThe study used a descriptive cross-sectional design. A total of 134 patients aged 18 years and above receiving inpatient treatment for substance use disorders were recruited into the study. A mental state exam was done to rule out active psychopathology. Data on socio demographic variables, adverse childhood experiences (ACEs) and substance use was collected using Adverse Childhood Experiences International Questionnaire and The Alcohol, Smoking and Substance Involvement Screening Test respectively. Data was analysed using statistical package for social sciences (SPSS) version 20 for windows.ResultsMales accounted for the majority of the study participants (n = 118, 88.1%). Only 43.3% (n = 58) of the participants had a family history of substance use disorder. The most frequently used substance was alcohol which was reported by 82.1% of the participants. Nearly 93% of the respondents had experienced at least one ACE and the most prevalent ACE was one or no parent which was reported by half of the respondents. The adverse childhood experiences significantly associated with current problematic substance use were; emotional abuse, having someone with mental illness in the household, physical abuse and physical neglect. Emotional abuse significantly predicted tobacco (A.O.R = 5.3 (1.2–23.9)) and sedative (A.O.R = 4.1 (1.2–14.2)) use. Childhood exposure to physical abuse was associated with cannabis use [A.O.R = 2.9 (1.0–7.9)]. Experiencing five or more ACEs was associated with increased risk of using sedatives.ConclusionThere is a high prevalence of adverse childhood experiences among patients with substance use disorders. Experiencing emotional abuse, having someone with mental illness in the household, physical abuse and physical neglect in childhood are risk factors of substance use disorders. ACEs screening and management should be incorporated in substance abuse prevention programs and policies.

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Childhood Abuse as a Factor in Attrition from Drug Rehabilitation

Cited by 30 publications

References 6 publications

Sensitivity of the Addiction Severity Index Physical and Sexual Assault Items: Preliminary Findings on Gender Differences

Sensitivity of the Addiction Severity Index Physical and Sexual Assault Items: Preliminary Findings on Gender Differences

Drinking to ease the burden: a cross-sectional study on trauma, alcohol abuse and psychopathology in a post-conflict context

Adverse childhood experiences among patients with substance use disorders at a referral psychiatric hospital in Kenya

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