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

Abstract

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.

Are Drinking Motives Universal? Characteristics of Motive Types in Alcohol-Dependent Men from Two Diverse Populations

“…Versions of the screening instruments in Luo, which is the local language in northern Uganda, have been previously created and utilized. The procedure of translation and adaptation is described elsewhere ( 71 , 72 ).…”

“…The AUDIT has been reported to accurately measure risk across gender, age, and cultures ( 84 , 85 ). The AUDIT had already been successfully employed in northern Uganda in previous research ( 72 , 86 ). Apart from the AUDIT, other alcohol-related indices were assessed in both samples.…”

Evaluation of childhood traumatic experience as a risk factor for alcohol use disorder in adulthood

“…It was hypothesized that the experience of ELS caused long-lasting modulation of neurons, as well as hyperactivity of the hypothalamuspituitary-adrenal (HPA) axis [15]. However, most research on the relationship between trauma and alcohol use disorders focus on a single age group, e.g., trauma happened during either childhood or adulthood [16,17]. Furthermore, most of the previous studies on prenatal period stress are animal studies [18].…”

Childhood trauma is predictive for clinical staging, alcohol consumption, and emotional symptoms in patients with head and neck cancer

“…Patients with HNC display emotional responses that may affect their adherence to treatment, the immunological response to the primary tumor and metastasis, and the maintenance of smoking and alcoholism. 8,9,27 Although traumatic events in childhood have been indicated as risk factors for the development and maintenance of the habitual consumption of these substances, 28,29 this association has not yet been explored in patients with HNSCC. Moreover, advanced clinical staging at the time of diagnosing the disease is the main prognostic factor in patients with cancer 30 ; however, the association between childhood trauma and clinical staging has not yet been explored in patients with HNSCC.…”