Drinking motives as mediators between PTSD symptom severity and alcohol consumption in persons with severe mental illnesses

O’Hare, Thomas; Sherrer, Margaret V.

doi:10.1016/j.addbeh.2011.01.006

Cited by 54 publications

(40 citation statements)

References 47 publications

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“…Some have suggested that this tendency to use substances to cope with negative emotions might be driven by personality traits (Blanchard et al), or a tendency for some clients to appraise stressful or traumatic events more negatively (Olff, Langeland, Draijer, & Gersons, 2007), or experience greater subjective distress from traumatic events or the consequences of high-risk behaviors (O'Hare et al, 2010;O'Hare, Sherrer, & Shen, 2006), problems for which women are at greater risk. However, research has yet to reveal consistent associations between motives to use and choice of general substance type (e.g., sedatives vs. stimulants) in clients with psychiatric disorders in general, many of whom are polysubstance users (e.g., Mueser et al, 1992;O'Hare & Sherrer, 2011). Future studies might focus on statistical models that link symptoms, motives, and specific substances of choice in much larger samples.…”

Section: Implications For Comorbidity Theory and Researchmentioning

confidence: 96%

“…In diagnostically mixed samples of clients with severe mental illness, coping motives were shown to correlate directly with posttraumatic stress disorder (PTSD) symptoms and primary diagnosis of a severe mental illness (O'Hare, Shen, & Sherrer, 2007, statistically mediate lifetime abuse and high-risk behaviors (O'Hare et al, 2010). Coping motives were also shown to mediate PTSD symptoms and amount of alcohol consumption to a greater degree than convivial (i.e., social enhancement) drinking motives (O'Hare & Sherrer, 2011). However, when clients with schizophrenia and mood disorders were compared directly, the latter were twice as likely to use coping motives (O'Hare et al, 2007(O'Hare et al, , 2010, findings very similar to a previous comparison of diagnostically similar groups of clients (Gearon et al, 2001).…”

Section: Substance Use Motives: a Theoretical Frameworkmentioning

confidence: 97%

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Substance Use Motives in People With Severe Mental Illness: Comparisons Among Four Diagnostic Groups

O’Hare

Sherrer

2012

Journal of Social Work Practice in the Addictions

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Research has consistently shown that alcohol consumption motivated by a desire to alleviate negative emotional states predicts alcohol use and relapse among clients with cooccurring psychiatric disorders. However, studies examining the role of drinking motives in people with severe mental illness are few. This study of 283 community mental health clients (43.8% men, 55.1% women), assigned a primary Axis I diagnosis of schizophrenia (28.3%), schizoaffective (23.3%), major depression (31.1%), or bipolar I disorder (17.3%), tested the hypothesis that clients with a diagnosis of mood disorder would report greater substance use, would indicate more problems associated with substance use, and would be more likely to use substances to cope with negative emotions than would clients with schizophrenia. In addition, coping motives would account for more variance in substance use and related problems than would convivial drinking when controlling for age, gender, and Axis I diagnosis. Results largely supported these hypotheses with some exceptions. Implications for theory, research, and practice with comorbid clients are suggested.

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Section: Implications For Comorbidity Theory and Researchmentioning

confidence: 96%

Section: Substance Use Motives: a Theoretical Frameworkmentioning

confidence: 97%

Substance Use Motives in People With Severe Mental Illness: Comparisons Among Four Diagnostic Groups

O’Hare

Sherrer

2012

Journal of Social Work Practice in the Addictions

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“…Studies examining the role of cognitions about substance use have found mixed results. Some researchers have found that people with more severe MHD symptoms reported greater expectations that substance use would reduce their negative symptoms (Bizzari et al, 2007;Bonn-Miller, Vujanovic, Tyler Boden, & Gross, 2011;O'Hare & Sherrer, 2011;Ullman, Filipas, Townsend, & Starzynski, 2005). However, Bizzari et al (2007) and Ullman et al (2005) also found that people with only a SUD (no co-occurring MHD) endorsed positive expectancies for alcohol at a similar or greater rate than those with co-occurring disorders.…”

Section: Mhd Leads To Sud-the Self-medication Modelmentioning

confidence: 96%

“…Thus, it may be that people with positive alcohol expectancies are more likely to use substances in response to positive and negative moods and that self-medication is not limited to people with diagnosable MHDs. It is important to note that all of the studies mentioned were cross-sectional, that is, data was collected at one point in time Bizzari et al, 2007;O'Hare & Sherrer, 2011;Ullman et al, 2005).…”

Section: Mhd Leads To Sud-the Self-medication Modelmentioning

confidence: 99%

Substance Use and Mental Health Disorders: Why Do Some People Suffer From Both?

Msw

Kobayashi

2012

Social Work in Mental Health

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Social workers intervene with clients with co-occurring substance use and mental health disorders in their daily practice. Many social workers may not have a full understanding of the theories about why people have co-occurring disorders. The theory that social workers are most familiar with, the self-medication model, may not best explain the client's experience and may cause social workers to overlook the needs of some clients. In this article, the four main models used to explain why people have co-occurring disorders are examined, empirical literature related to each model is critiqued, and implications for practice, policy, and research are discussed.

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“…The authors referred to studies on coping, among others. For example, motives to drink to cope with negative emotions, in particular, have been shown to mediate PTSD symptomalcohol consumption comorbidity (O'Hare & Sherrer, 2011).…”

Section: Shared Vulnerability Modelmentioning

confidence: 99%

PTSD-SUD Comorbidities in the Context of Psychological Injury and Law

Young

Wang²

2015

Psychol. Inj. and Law

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Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) are both common psychological problems and they are frequently comorbid. However, there is little longitudinal research that can disentangle their temporal relationship towards determining the mechanisms in their comorbidity. Furthermore, the extant research does not consider possible confounds to diagnosis that are relevant to the area of psychological injury and law, such as exclusion of cases of malingering after appropriate assessment and testing. This paper reviews the literature on the question of comorbidity of PTSD and SUD towards establishing preliminary conclusions that could serve directions for needed research in the area, and with potential application to individual assessment and court purposes. There are four major models in how PTSD and SUD relate-selfmedication, high risk, susceptibility, and shared vulnerability. Overall, the self-medication model is supported, but not exclusively. Recent research is examining the different models in these regards with respect to individual differences, including in negative emotionality/constraint, emotional/dysregulation, and patterns in PTSD's different clusters. Further research is required from a forensic perspective that uses the appropriate populations, rules out malingering in the cases studied, and controls other confounds applicable to the forensic context. This article examines models of the comorbidity of posttraumatic stress disorder (PTSD) and substance use disorder (SUD), concentrating on alcohol use disorder (AUD). The disorders often co-occur, and their comorbidity in cases of psychological injury presents difficulties both to assessors and attorneys involved in the cases. For example, after an event at claim in which PTSD develops, does the alcohol consumption that might ensue reflect (a) a response to the trauma and PTSD, as in self-medication to alleviate the symptoms; (b) the continuation of a pre-existing alcohol consumption, perhaps exacerbated by the trauma/PTSD; (c) an underlying psychological construct or personality trait fully unrelated to the trauma/PTSD (e.g., lack of inhibition, high-risk behavior, externalizing behavior); or (d) other possibilities, ranging from the effects of drinking and driving to a multifactorial causality with at least two if not all these factors involved, including reciprocally and in mutual maintenance and exacerbation?The article is organized into sections that first cover PTSD and AUD as presented in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; American Psychiatric Association, 2013). Then, the article considers the prevalence of PTSD/SUD (AUD) comorbidity as found in a variety of recent studies. Next, the article examines the major models on PTSD-SUD (AUD) comorbidity and the research cited in the recent publications presenting these models. Next, the article analyzes in depth the empirical research in these recent studies on the comorbidity of PTSD and SUD (AUD). For this purpose, we used a tabular...

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Drinking motives as mediators between PTSD symptom severity and alcohol consumption in persons with severe mental illnesses

Cited by 54 publications

References 47 publications

Substance Use Motives in People With Severe Mental Illness: Comparisons Among Four Diagnostic Groups

Substance Use Motives in People With Severe Mental Illness: Comparisons Among Four Diagnostic Groups

Substance Use and Mental Health Disorders: Why Do Some People Suffer From Both?

PTSD-SUD Comorbidities in the Context of Psychological Injury and Law

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