PTSD as a Risk Factor Predicting Polydrug Use: A Dual Systems of Self-Control Mediation Model

Abstract

Post-traumatic stress disorder (PTSD) is associated with increased risk for polydrug use. Low self-control is a key characteristic of the disorder and is predictive of polydrug use. However, there is a dearth of research focused on the relevance of a dual systems model delineation of self-control into the constructs of risk-seeking and impulsivity as it pertains to polydrug use and PTSD. This study tested dual systems mediation of this relationship. Generalized structural equation modeling was used to test for mediation effects. Results indicated that more PTSD symptoms predicted increased drug use variety (coefficient = 0.024; confidence interval [CI] = [0.001, 0.046]). Inclusion of dual systems constructs fully attenuated this relationship. The total indirect effect achieved marginal significance (coefficient = 0.005; CI = [>−0.001, 0.009]). Sensitivity analyses of the specific indirect effect of impulsivity as the sole mediator indicated significant mediation. These results provide some indication that impulsivity-based programming may help to treat polydrug use among those with severe PTSD.

Do Risk Preferences Change? Evidence from the Great East Japan Earthquake

“…Our data is the panels of nationally representative surveys that follow risk preferences of the same individuals before and one and five years after the Earthquake. 4 In fact, Chuang and Schechter (2015), the most recent and comprehensive survey on this topic, point out that data on preferences is usually only available after the event and not before. This is especially the case of natural disasters because researchers cannot anticipate where natural disasters will occur.…”

“…Gallagher (2014) also shows that flood insurance take-up spikes the year after a flood but then steadily declines to the baseline. 4 Notable exceptions that use panel data include Brunnermeier and Nagel (2008), Sahm (2012), and Guiso, Sapienza, and Zingales (2013), who examine shocks in financial domain. Our study differs from theirs as our shocks fall within the nonfinancial domain (i.e., more physical).…”

PTSD as a Predictor of Differential Development of Dual Systems Model Constructs: A Group-Based Trajectory Modeling Approach

“…PTSD was also hypothesized to predict patterns of high sensation-seeking in a manner consistent with numerous theories of risk-seeking behavior observed among individuals with PTSD (Kerig, 2019). With traumatic stress and PTSD observed at high rates among JIY and also serving as risk factors predicting risk for engagement in a range of deleterious outcomes (Fagan et al, 2015; Karatzias et al, 2018; Peltonen et al, 2020; Robertson et al, 2004; Wojciechowski, 2020a), these findings yield relevant information regarding how to potentially provide treatment to JIY presenting with PTSD that may facilitate desistance from harmful behaviors. These findings suggest that focusing on sensation-seeking among these youth may be the more fruitful route of treatment if assuming a dual systems model approach.…”

“…In this way, adolescents develop the drive to seek out thrilling behaviors that may present a relatively high degree of risk and are rewarded and reinforced with dopamine, but do not develop the capacity to stop and consider the consequences of engagement until much later in life. In this way, the dual systems model has helped to explain the peak prevalence of engagement in risky behaviors during adolescence and has been applied as an explanatory framework able to predict a range of such behaviors (Ellingson et al, 2019; Wasserman et al, 2017; Wojciechowski, 2020a). However, while typical development in these constructs has been examined to a large extent, there exist gaps in our understanding of heterogeneity that may exist in the development of these constructs and factors that may drive differential development.…”

Testing Relationships Between Exposure to Violence and Substance Use: Comparing Cognitive and Mental Health Mediation and Integrating Propensity Score Matching

“…One of the few examinations in this area focused on posttraumatic stress disorder and polydrug use, with the finding that variation in impulsivity may be relevant for mediating this relationship. 36 This study's focus on this topic may be particularly relevant given that adolescence is a developmentally sensitive period pertaining to these processes. This sensitivity may mean that these constructs may be prone to alteration given exposure to violence during adolescence, leading to divergence from typical cognitive development.…”