Suicidal ideation among adults with a recent sexual assault: Prescription opioid use and prior sexual assault

Gilmore, Amanda K.; Hahn, Christine K.; Jaffe, Anna E.; Walsh, Kate; Moreland, Angela D.; Ward‐Ciesielski, Erin F.

doi:10.1016/j.addbeh.2018.05.028

Cited by 8 publications

(7 citation statements)

References 40 publications

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“…Despite these differences, gender is often overlooked in research about contributing factors in differences in prescription opioid use (Mazure & Fiellin, 2018). Most studies examining the relationship between trauma and opioid use limited their sample to women (Gilmore et al, 2018;Stene et al, 2012;Walsh et al, 2015;Wuest et al, 2007) or controlled for gender, that is, did not examine differential associations by gender Douglas et al, 2010;Stein et al, 2017). The few studies specifically examining gender differences show that among prescription opioid users, women are more likely to report a history of trauma (Balousek et al, 2007;Schafer et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

The Effects of Co-Occurring Interpersonal Trauma and Gender on Opioid Use and Misuse

Williams

Girdler

Williams³

et al. 2020

J Interpers Violence

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The association between interpersonal trauma (IPT) and opioid misuse is well established. There are important gaps, however, in our understanding of this relationship. Studies often do not account for the co-occurrence of IPT across time (i.e., multiple experiences of the same type of IPT) and contexts (i.e., experiences of different types of IPT). In addition, few studies have examined the relationship between IPT and prescription opioid use or gender differences. To address these gaps, this study examines the impact of IPT co-occurrence and gender on prescription opioid use and opioid misuse. Data were collected through a cross-sectional online survey of 235 adults with a self-reported history of IPT (i.e., intimate partner violence, sexual assault, adverse childhood experiences). IPT co-occurrence and interactions between IPT, as continuous scales, were assessed as correlates of opioid use and misuse using multinomial regression models. IPT was associated with opioid misuse, but not use, adjusting for gender. The relationship between sexual assault and opioid misuse was confounded by exposure to other types of IPT. Intimate partner violence was associated with opioid misuse among men. Adverse childhood experiences were associated with misuse among women. The interaction between intimate partner violence and sexual assault increased odds of opioid use among women. This study highlights the importance of accounting for IPT co-occurrence and examining gender differences in clinical practice and research related to opioid use/misuse. These approaches are important for understanding the relationship between IPT and opioid use/misuse by more accurately representing the complexity of the lives of survivors.

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Section: Introductionmentioning

confidence: 99%

The Effects of Co-Occurring Interpersonal Trauma and Gender on Opioid Use and Misuse

Williams

Girdler

Williams³

et al. 2020

J Interpers Violence

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“…Response options were "yes" or "no." Consistent with prior work (Gilmore et al, 2018), we considered those who responded "yes" to this question to have a history of prior sexual assault.…”

Section: Methodsmentioning

confidence: 99%

Acute Stress Symptoms After Forcible and Substance-Involved Rapes

Jaffe

Hahn

Gilmore

2019

Psychology of Women Quarterly

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In the early aftermath of a sexual assault, survivors often experience symptoms of distress including reexperiencing, avoidance, and hyperarousal symptoms. However, less is known about associations between rape characteristics and the nature of early reactions. We designed the current study to examine the unique and combined associations between use of force and substances during rape on acute stress symptoms. Participants were 56 women (ages 18–58) who completed a sexual assault medical forensic exam in the emergency department within 120 hours of the rape and then completed a follow-up clinical phone screening within 30 days of the forensic exam. Follow-up assessments included characteristics of the recent rape (force, substances), history of prior sexual assault, demographics, and symptoms of acute stress. Multivariate regression analyses revealed that, after controlling for prior sexual assault, sexual orientation, and race/ethnicity, there were no significant differences on any symptom cluster by rape type. However, this study involved a small, difficult-to-reach sample and, therefore, was only powered to detect large effect sizes. We encourage more research examining potentially unique, early symptom presentations for substance-involved rapes.

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“…Recent estimates indicate 43.6% of women and 24.8% of men experience sexual assault (SA) in their lifetime, which includes rape, being made to penetrate someone else, sexual coercion, and unwanted sexual contact (Smith et al, 2018 ). SA is the most robust predictor of posttraumatic stress disorder (PTSD) compared to other trauma types (Birkeland, Skar, & Jensen, 2021 ; Kessler et al, 2017 ) and is strongly associated with substance use disorders (SUD) and suicidality (Gilmore et al, 2018 ; Langdon et al, 2017 ). Physical impacts include injury, sexually transmitted infection, long-term health issues, and impairment in sexual functioning (Amstadter, McCauley, Ruggiero, Resnick, & Kilpatrick, 2011 ).…”

mentioning

confidence: 99%

“…Adverse psychological consequences include depression, anxiety, self-blame, mistrust, substance use, impulsivity and risk-taking (Basile & Smith, 2011 ). SA also incurs significant economic and social costs from use of medical, mental health (MH), forensic, criminal justice, and social services, and decreased relational and occupational functioning (Basile & Smith, 2011 ; Gilmore et al, 2018 ).…”

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confidence: 99%

Drug-facilitated sexual assault, impaired trauma memory, and implications for mental health treatment

Fields

Young

Patel

et al. 2022

European Journal of Psychotraumatology

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Background Sexual assault (SA) is a highly prevalent global public health problem and a robust predictor of posttraumatic stress disorder (PTSD), substance use disorder (SUD), and suicidality. A large percentage are drug or alcohol facilitated (DFSA), impairing trauma memory and affecting the application of evidence-based treatments. Despite these problems, few have investigated DFSA-specific mental health (MH) needs. Objective Goals of this study were (1) to identify psychological sequelae characterizing DFSA towards explaining why symptoms have been treatment-refractory, comparing survivors with involuntary substance ingestion (forced, covert: DFSA-I), voluntary ingestion (DFSA-V), and non-DFSA; and (2) to determine how impaired trauma memory relates to the development of PTSD and depression symptoms. Method Data from a retrospective chart review of 74 adults receiving SA MH services at an outpatient trauma center are presented. The sample includes a 2-year cohort seen acutely at an urban rape treatment center. The study is one of the first to examine therapy records beyond case studies for DFSA. Logistic, Poisson, and negative binomial regression analyses of quantitative data and qualitative thematic analysis of trauma cognitions and treatment foci were conducted. Results DFSA-V had five times greater odds of SUD, and notable substance-related self-blame compared to DFSA-I. DFSA-I had prominent relationship distress and self-blame for missing danger of perpetrator drugging. Survivors with impaired trauma memory had significantly fewer hyper-arousal and overall PTSD symptoms, and specifically less hypervigilance. No differences were found in re-experiencing symptoms. Conclusion Impaired trauma memory is common in DFSA and is associated with fewer baseline hyper-arousal and overall PTS. Despite this, DFSA issues including re-experiencing symptoms that are particularly distressing without the ability to cognitively connect the intrusions contribute to increased treatment needs. Impaired memory limits the application of evidence-based treatments, and collectively these findings call for the development of trauma-specific treatment protocols to enhance recovery for DFSA survivors. HIGHLIGHTS Survivors of drug-facilitated sexual assault have prominent PTSD including reexperiencing, though trauma memory may not be encoded. • Those absent trauma memory have less hyperarousal, but DFSA complications explain why it is treatment refractory and inform treatment development.

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Suicidal ideation among adults with a recent sexual assault: Prescription opioid use and prior sexual assault

Abstract: Routine screening at the emergency department for PO use and prior SA may help prevention efforts for suicide among adults who recently experienced SA.

Cited by 8 publications

References 40 publications

The Effects of Co-Occurring Interpersonal Trauma and Gender on Opioid Use and Misuse

The Effects of Co-Occurring Interpersonal Trauma and Gender on Opioid Use and Misuse

Acute Stress Symptoms After Forcible and Substance-Involved Rapes

Drug-facilitated sexual assault, impaired trauma memory, and implications for mental health treatment

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