Traumatic Stress and Gender Differences in Relationship to Substance Abuse, Mental Health, Physical Health, and HIV Risk Behavior in a Sample of Adolescents Enrolled in Drug Treatment

Abstract

Research on traumatic stress (TS) among adolescent substance users is limited, with research indicating that not all adolescents who experience trauma are substance users and not all adolescent substance users report symptoms of TS. In the general adolescent population, research on TS symptoms indicates gender differences, with more females reporting traumatic life events and more symptoms associated with traumatic stress. A gap in research exists, however, with regard to gender differences among adolescent substance users who report low versus acute levels of TS symptoms. This study included 274 male and 104 female adolescents enrolled in four drug treatment programs in Arizona. Comparisons between males and females and those with low versus acute levels of TS symptoms were examined with regard to substance use, mental health, physical health, and HIV risk-taking behavior. Results indicate significant differences between males and females and between those reporting low versus acute TS. In general, females and those with acute levels of TS symptoms had higher levels of substance use, mental health, and physical health problems as well as greater HIV risk behaviors when compared to males and those with low levels of TS symptoms. Results of this study indicate the need to assess adolescents for TS, including victimization and maltreatment histories, when entering substance abuse treatment and the need to simultaneously address issues of substance use, TS, and related mental health, physical health, and HIV sex risk behavior while in treatment.

Prevalence and comorbidity of major internalizing and externalizing problems among adolescents and adults presenting to substance abuse treatment

“…Any past-year traumatic distress was defined as 5 or more of 13 symptoms on the GAIN's Traumatic Stress Scale (TSS), which is a count of past-year symptoms related to PTSD, acute stress disorder, or other disorders of extreme stress such as childhood maltreatment or complex combinations of multiple past and current traumas. The TSS is based on the Mississippi Scale for PTSD that has proven useful for identifying problems after combat exposure, natural disaster, interpersonal violence and maltreatment (Hyer et al, 1991;Stevens, Murphy & McKnight, 2003). We have used the general form here because most clients were reporting symptoms related to multiple current and past traumas and the most common single one was child maltreatment which the national guidelines suggest does not fit well into the technical definition of PTSD per se (Foa, Keane, & Friedman, 2000).…”

What is the association between traumatic life events and alcohol abuse/dependence in people with and without PTSD? Findings from a nationally representative sample

“…Traumatic events are experienced by 60-90% of the general population, [1] and are linked with an array of negative mental health consequences; [2] however, only a minority of individuals exposed to traumatic events respond in a pathological way. Posttraumatic stress disorder (PTSD), for example, affects only 5-10% of those exposed to trauma (for review, see [1,3] ).…”

Effects of Integrated Trauma Treatment on Outcomes in a Racially/Ethnically Diverse Sample of Women in Urban Community-based Substance Abuse Treatment

“…Women with acute levels of traumatic stress show higher levels of substance use, mental and physical health problems, and greater HIV risk behaviors, compared to men and women with lower traumatic symptomatology. 7 Moreover, for those persons receiving treatment for mental health disorders and/or posttraumatic stress/substance use disorders, higher dropout rates are reported for persons with a history of physical or sexual abuse or a history of child abuse/neglect. 8 Amaro et al 9 also reported that Latina women with a history of childhood abuse receiving services in a residential substance abuse program were more likely to drop out in the early stages of treatment than those without such history.…”