Trauma and post-traumatic stress disorder in a drug treatment community service

Abstract

Aims and methodA cross-sectional study aiming to assess the prevalence of trauma and post-traumatic stress disorder (PTSD) in a community substitution treatment sample, and to assess and compare the characteristics of traumatic experience, substance use, and psychological and social factors in those with and without PTSD. All assessments were completed during the interview which took approximately 1.5 h.ResultsThe prevalence for current PTSD was 26.2% and for lifetime PTSD 42.9%. Traumatic experiences were extremely common, with two or more reported by 92.9% of the sample. The two groups differed significantly on the majority of psychological functioning and social variables, with women experiencing higher rates of PTSD and the non-PTSD group having lower rates of psychological impairment.Clinical implicationsThe research supported findings from previous studies. The very high incidence of traumatic experiences has not been reported before. Training and information about trauma and PTSD for substance misuse workers are therefore necessary so that PTSD can be more easily detected and treated.

Intrusive memories of trauma in PTSD and addiction

“…Substance use increased after the target trauma for approximately two-thirds, independently of the diagnosis of PTSD, suggesting that it is either not specific to PTSD, or that some participants may have had a lifetime diagnosis of PTSD as reported in Reynolds et al 6,7 The results from this study need to be interpreted with caution. The sample included patients with substance use disorders attending out-patient and in-patient services for detoxification from substances rather than patients attending PTSD services.…”

“…The sample included patients with substance use disorders attending out-patient and in-patient services for detoxification from substances rather than patients attending PTSD services. Although the out-patient and in-patient samples of the study are not significantly different from each other as far as traumatic experience, substance use, associated psychological and social factors are concerned, 6 they may not be representative of the overall population attending PTSD, emergency or military support services.…”

“…This is consistent with previous studies. What appears to differentiate the PTSD and non-PTSD groups is the higher level of psychological distress experienced and the social impact of the trauma on the lives of the former, 6,7 as expected, given that those with a diagnosis of PTSD by definition have more symptoms and greater impairment than those without the diagnosis.…”

“…Further details concerning trauma and PTSD can be found in Reynolds et al 6,7 The subsequent analyses in this report will involve comparisons between the PTSD group and the non-PTSD group. The former includes those who fulfilled the criteria for a DSM-IV-TR diagnosis at the time of the interview, the non-PTSD group therefore includes those who did not meet criteria for the diagnosis and also those who met criteria for a partial diagnosis as described earlier, as in Reynolds et al 7 The 'partial PTSD' group were included in the non-PTSD group for the main analysis because on the whole their scores were within the range of the non-PTSD group.…”

“…Such traumas and many others are also common in the risk-taking lifestyle of those who use substances. [6][7] This study is part of a larger project exploring the relationship between trauma, PTSD and substance use disorders in UK clinical populations; other aspects of the project are reported by Reynolds et al 6,7 The aim of this study is to analyse the nature and characteristics of intrusive phenomena relating to traumatic experiences in a cohort that comprises a community sample seeking treatment for substance use disorders and an in-patient sample from a specialist in-patient addiction service in south London. The perceived effect of drugs and drug use on traumatic intrusion and memory experiences will also be explored.…”