title: Patterns of drug and alcohol use associated with lifetime sexual revictimization and current posttraumatic stress disorder among three national samples of adolescent, college, and household-residing women.
abstract: Sexual revictimization (experiencing 2 or more rapes) is prevalent and associated with increased risk for posttraumatic stress disorder (PTSD) and substance use. However, no national epidemiologic studies have established the prevalence or relative odds of a range of types of substance use as a function of sexual victimization history and PTSD status. Using three national female samples, the current study examined associations between sexual revictimization, PTSD, and past-year substance use. Participants were 1763 adolescent girls, 2000 college women, and 3001 household-residing women. Rape history, PTSD, and use of alcohol, marijuana, other illicit drugs, and non-medical prescription drugs were assessed via structured telephone interviews of U.S. households and colleges in 2005-2006. Chi-square and logistic regression were used to estimate the prevalence and odds of past-year substance use. Relative to single and non-victims: Revictimized adolescents and household-residing women reported more other illicit and non-medical prescription drug use; revictimized college women reported more other illicit drug use. Past 6-month PTSD was associated with increased odds of drug use for adolescents, non-medical prescription drug use for college women, and all substance use for household-residing women. Revictimization and PTSD were associated with more deviant substance use patterns across samples, which may reflect self-medication with substances. Findings also could be a function of high-risk environment or common underlying mechanisms. Screening and early intervention in pediatric, primary care, and college clinics may prevent subsequent rape, PTSD, and more severe substance use.
authors.affiliation: Department of Epidemiology, Columbia University, United States. Electronic address: klw2153@musc.edu.
authors.forename: Kate
authors.initials: K
authors.lastname: Walsh
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, United States.
authors.forename: Heidi S
authors.initials: HS
authors.lastname: Resnick
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, United States.
authors.forename: Carla Kmett
authors.initials: CK
authors.lastname: Danielson
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, United States.
authors.forename: Jenna L
authors.initials: JL
authors.lastname: McCauley
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, United States.
authors.forename: Benjamin E
authors.initials: BE
authors.lastname: Saunders
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, United States.
authors.forename: Dean G
authors.initials: DG
authors.lastname: Kilpatrick
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D002648:Child; D019548:Crime Victims / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015995:Prevalence; D011902:Rape / Q000706:statistics & numerical data*; D012307:Risk Factors; D012742:Sex Offenses / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D013334:Students / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D014495:Universities; D055815:Young Adult
keywords: PTSD; Rape; Substance use