title: Posttraumatic stress avoidance symptoms as mediators in the development of alcohol use disorders after exposure to childhood sexual abuse in a Swiss community sample.
abstract: This study examined the role of posttraumatic stress disorder (PTSD) symptoms of re-experience, avoidance, and hyperarousal in the relationship between different types of trauma and alcohol use disorders (AUD). We used data from 731 trauma-exposed individuals who participated in the first wave of the PsyCoLaus-study. Trauma characteristics were assessed relatively to the occurrence of lifetime PTSD symptoms and AUD. The results suggest that lifetime and childhood sexual abuse as well as overall childhood trauma were directly linked to AUD and PTSD symptoms, in particular to avoidance symptoms. From single symptom clusters PTSD avoidance was found to specifically mediate the trauma-AUD pathway. Both childhood and sexual trauma strongly contribute to the comorbidity of PTSD and AUD and avoidance-type symptoms appear to play a central role in maintaining this association. Hence, the alleviation of avoidance symptoms might be an important target for therapeutic intervention among victims of sexual abuse before specific addiction treatment is initiated.
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Militärstrasse 8, 8021 Zurich, Switzerland.
authors.forename: Mario
authors.initials: M
authors.lastname: Müller
authors.affiliation: Department of Psychiatry, CHUV, Site de Cery, 1008 Prilly, Lausanne, Switzerland.
authors.forename: Caroline
authors.initials: C
authors.lastname: Vandeleur
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Militärstrasse 8, 8021 Zurich, Switzerland.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Rodgers
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Militärstrasse 8, 8021 Zurich, Switzerland; Collegium Helveticum, University of Zurich and Swiss Federal Institute of Technology, Schmelzbergstrasse 25, 8092 Zurich, Switzerland; Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of Sao Paulo, Medical School, 05403-010 Sao Paulo, SP, Brazil.
authors.forename: Wulf
authors.initials: W
authors.lastname: Rössler
authors.affiliation: Department of Psychiatry, CHUV, Site de Cery, 1008 Prilly, Lausanne, Switzerland.
authors.forename: Enrique
authors.initials: E
authors.lastname: Castelao
authors.affiliation: Department of Psychiatry, CHUV, Site de Cery, 1008 Prilly, Lausanne, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Preisig
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Militärstrasse 8, 8021 Zurich, Switzerland.
authors.forename: Vladeta
authors.initials: V
authors.lastname: Ajdacic-Gross
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology / Q000706:statistics & numerical data; D000368:Aged; D019973:Alcohol-Related Disorders / Q000209:etiology*; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012651:Self Medication / Q000523:psychology / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology*; D013557:Switzerland / Q000453:epidemiology
keywords: Alcohol use disorders; Childhood sexual abuse; Community sample; Comorbidity; Posttraumatic stress symptoms; Self-medication model