Substance use, childhood traumatic experience, and Posttraumatic Stress Disorder in an urban civilian population.
OBJECTIVE
Exposure to traumatic experiences, especially those occurring in childhood, has been linked to substance use disorders (SUDs), including abuse and dependence. SUDs are also highly comorbid with Posttraumatic Stress Disorder (PTSD) and other mood-related psychopathology. Most studies examining the relationship between PTSD and SUDs have examined veteran populations or patients in substance treatment programs. The present study further examines this relationship between childhood trauma, substance use, and PTSD in a sample of urban primary care patients.


METHODS
There were 587 participants included in this study, all recruited from medical and OB/GYN clinic waiting rooms at Grady Memorial Hospital in Atlanta, GA. Data were collected through both screening interviews as well as follow-up interviews.


RESULTS
In this highly traumatized population, high rates of lifetime dependence on various substances were found (39% alcohol, 34.1% cocaine, 6.2% heroin/opiates, and 44.8% marijuana). The level of substance use, particularly cocaine, strongly correlated with levels of childhood physical, sexual, and emotional abuse as well as current PTSD symptoms. In particular, there was a significant additive effect of number of types of childhood trauma experienced with history of cocaine dependence in predicting current PTSD symptoms, and this effect was independent of exposure to adult trauma.


CONCLUSIONS
These data show strong links between childhood traumatization and SUDs, and their joint associations with PTSD outcome. They suggest that enhanced awareness of PTSD and substance abuse comorbidity in high-risk, impoverished populations is critical to understanding the mechanisms of substance addiction as well as in improving prevention and treatment.
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia 30329, USA.
Lamya
L
Khoury
Yilang L
YL
Tang
Bekh
B
Bradley
Joe F
JF
Cubells
Kerry J
KJ
Ressler
D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D002650:Child Abuse, Sexual / Q000523:psychology / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D005845:Georgia; D006801:Humans; D013287:Illicit Drugs; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D012307:Risk Factors; D012959:Socioeconomic Factors; D013223:Statistics as Topic; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D014505:Urban Population / Q000706:statistics & numerical data*
D013287:Illicit Drugs