Co-morbid post-traumatic stress disorder in a substance misusing clinical population

Reynolds, Martina; Mezey, Gillian; Chapman, Murray; Wheeler, M. J.; Drummond, Colin; Baldacchino, Alex

doi:10.1016/j.drugalcdep.2004.08.017

Cited by 189 publications

(165 citation statements)

References 21 publications

Supporting

Mentioning

138

Contrasting

Unclassified

Order By: Relevance

“…9 Increased trauma exposure has been linked to disproportionate physical health burdens, including chronic physical symptoms, poorer health perceptions, and higher rates of neurological and cardiovascular problems (e.g., heart failure, and stroke). 8,10,11 Furthermore, women with SUDs and co-occurring PTSD are more likely, than those without PTSD, to be diagnosed with a mood disorder, to report higher rates of depressive symptoms, and to have attempted suicide. 12 Due to the greater likelihood of women presenting to general medical settings before they present for SUD treatment, primary care providers may have increased access to earlier screening.…”

Section: Introductionmentioning

confidence: 99%

Posttraumatic Stress Disorder, Health Problems, and Depression Among African American Women in Residential Substance Use Treatment

Meshberg‐Cohen

Presseau

Thacker

et al. 2016

Journal of Women's Health

View full text Add to dashboard Cite

Background: Rates of posttraumatic stress disorder (PTSD) are high among women seeking treatment for substance use disorders (SUDs). Minority women, in particular, experience high rates of trauma and may be less likely to disclose trauma history. This article identifies items from pre-existing screening measures that can be used across settings to sensitively but noninvasively identify women with likely PTSD. Method: For a sample of 104 African American women in residential SUD treatment who provided informed consent as a part of a larger randomized clinical trial, the prevalence of trauma and PTSD, as well as the relationships between trauma, health, depression, and distress, was examined. Measures included Posttraumatic Stress Diagnostic Scale (PDS), Center for Epidemiologic Studies-Depression Scale (CES-D), Pennebaker Inventory of Limbic Languidness (PILL), and Brief Symptom Inventory (BSI). Additional analyses were undertaken to determine if a subset of noninvasive items could serve to identify the presence of a probable PTSD diagnosis. Results: Most women (94.2%) reported at least one lifetime trauma, with over half (51.0%) meeting DSM-IV criteria for PTSD. Women with greater trauma symptom severity reported more health problems and higher levels of depression and distress. Five BSI items and one CES-D item were significantly associated with a probable PTSD diagnosis with a sensitivity of 88.7%, a specificity of 66.7%, a positive predictive value of 73.4%, a negative predictive value of 85.0%, and an accuracy of 77.9%. Conclusion: Findings affirm that African American women with SUDs present for residential treatment with comorbid psychiatric and emotional conditions that warrant assessment and treatment. Results highlight potential benefits of brief screening with routine measures and coordinated access to ancillary psychiatric and medical services, in conjunction with substance treatment, such as in residential or primary care.

show abstract

Section: Introductionmentioning

confidence: 99%

Posttraumatic Stress Disorder, Health Problems, and Depression Among African American Women in Residential Substance Use Treatment

Meshberg‐Cohen

Presseau

Thacker

et al. 2016

Journal of Women's Health

View full text Add to dashboard Cite

show abstract

“…Indeed, drug users have one of the highest rates of PTSD among any clinical population, with most prevalence estimates ranging over 25%. 1,2 PTSD and other psychiatric disorders precipitated by traumatic events convey considerable disease burden to drug users, through the direct effects of psychiatric symptoms and the indirect effects of these symptoms on drug use and response to substance abuse treatment. 4,5 In view of the high rates of lifetime traumatic event exposure in drug users, it is remarkable that so little is known about rates of trauma re-exposure in this high-risk population.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 Traumatic events cause considerable psychiatric distress and increase risk of subsequent psychiatric problems, including posttraumatic stress disorder 3 (PTSD). Indeed, drug users have one of the highest rates of PTSD among any clinical population, with most prevalence estimates ranging over 25%.…”

Section: Introductionmentioning

confidence: 99%

Traumatic Event Re-exposure in Injecting Drug Users

et al. 2011

View full text Add to dashboard Cite

Drug users have very high rates of lifetime exposure to traumatic events, leading to significant psychiatric complications. In spite of the high rate of lifetime exposure, very little is known about the rate of ongoing re-exposure to new traumatic events in drug users. We investigated the rate of traumatic event re-exposure in male and female injecting drug users using syringe exchange services in Baltimore (N=197). Participants were assessed monthly for traumatic event re-exposure for 16 months. Averaged over the entire follow-up period, 27% of participants were re-exposed to a traumatic event each month and 72% were re-exposed over the 16-month study period. Women were over twice as likely to report any traumatic event re-exposure as men (adjusted odds ratio [AOR]=2.48; 95% CI=1.54-3.99), with the specific events of lifethreatening illness, death of a loved one, and injury or illness of a loved one being more common in women than men. Traumatic event re-exposure occurs far more often than previously reported, with women injecting drug users at the highest risk. Reassessment of traumatic events may help to identify people most in need and encourage entry into treatment.

show abstract

“…First, the levels of PTSD and the proposed mediator and moderator variables in this sample were at levels consistent with published research on individuals who pathologically gamble (Williams, Grisham, Erksin, & Cassedy, 2012), higher than individuals with alcohol abuse (Fox, Hong, & Sinha, 2008), and similar to individuals with Bi-Polar Disorder (Swann, Lijffjit, Lane, Steinberg, & Moeller, 2009). Furthermore, the rate of PTSD in this population is almost twice that of previous research (Reynolds et al, 2005). This highlights the extraordinary amount of factors which have the potential for decreasing this population's chance at successful recovery from drug and alcohol abuse.…”

Section: Discussionsupporting

confidence: 60%

“…Research suggests that 40% of individuals undergoing SUD rehabilitation have comorbid PTSD (Reynolds et al, 2005). As PTSD tends to be viewed as a difficult to treat diagnosis with potentially long individual therapy times, and unpredictable treatment adherence (Gielen, Krumeich, Havermans, Smeets, & Jansen, 2014), the TC method of treatment is particularly relevant (Calhoun, 2003).…”

Section: Defining the Therapeutic Communitymentioning

confidence: 99%

Posttraumatic stress disorder in a therapeutic community for substance use disorders: an evaluation of the influence

Perryman¹

View full text Add to dashboard Cite

The purpose of this body of research is twofold. First, to investigate posttraumatic stress disorder (PTSD) in a sample of adults undergoing substance use disorder (SUD) treatment in a therapeutic community (TC) and, second, to apply major psychological theories to help understand the nature of this comorbidity in ways that inform treatment. The focal theories of this research are: emotion dysregulation (Gratz & Roemer, 2004), and revised Reinforcement Sensitivity Theory (rRST; Corr, 2008;Gray & McNaughton, 2000). Rash Impulsiveness will be included as an important dimension of rRST that has been consistently linked to substance misuse. Chapter 1 presents an overview of research related to the thesis as a whole. In Chapter .72, p < .00). Furthermore, the correlations between PTSS and two of the facets of rRST, BAS and fight-flight-freeze sensitivity (FFFS), were significantly correlated (r = -.23 and .49, p < .01, respectively). BAS sensitivity was shown to negatively correlate with PTSS, indicating that lower BAS sensitivity related to higher PTS severity. No relationship was found between the Behavioural Inhibition System (BIS) and PTSS. Finally, Rash Impulsivity significantly correlated with PTSS at intake, r = .50, p < .00. Contrary to hypotheses, and previous research, Rash Impulsivity did not significantly correlate with retention. Theoretical mechanisms linking PTSS and substance misuse were investigated further, with tests of theoretical models in which individual difference factors (facets of the rRST) were related to retention and outcomes from treatment, and facets of emotional dysregulation were tested as mediators of this relationship. Upon investigation through linear regression, no suitable variable was found the mediate the relationship between PTSS and retention.iii The final moderated mediated model, therefore, was not suitable for this population. Limited moderation, though, occurred between the two facets of rRST and retention. Specifically, investigation of the simple slopes showed that FFFS and Rash Impulsivity both moderate the relationship between PTSD and retention at high (+1 SD) and mean scores. These findings indicate that high levels of both facets do interact with PTSD to negatively influence treatment retention.The null findings for both mediation and the moderated mediation model contradict previous research, and may be due to homogeneity in scores across the population. Overall, some implications for treatment can be extrapolated. First, PTSD is highly prevalent in the TC population, and should be assessed using psychometrically valid measures, such as the PCL-C, and addressed in treatment. Second, treatment for SUD does not exacerbate PTSD; on the contrary, PTSS significantly decreased during TC treatment. Finally, as there is solid theoretical support to suggest an influence of emotion dysregulation and Rash Impulsiveness on retention and outcomes, more research needs to be conducted on the role of these two constructs with the intent of creating a better suited rehabi...

show abstract

Co-morbid post-traumatic stress disorder in a substance misusing clinical population

Cited by 189 publications

References 21 publications

Posttraumatic Stress Disorder, Health Problems, and Depression Among African American Women in Residential Substance Use Treatment

Posttraumatic Stress Disorder, Health Problems, and Depression Among African American Women in Residential Substance Use Treatment

Traumatic Event Re-exposure in Injecting Drug Users

Posttraumatic stress disorder in a therapeutic community for substance use disorders: an evaluation of the influence

Contact Info

Product

Resources

About