A population-based study of help seeking and self-medication among trauma-exposed individuals.
Epidemiologic studies of trauma highlight the imbalance between prevalence of psychiatric diagnoses and help seeking. We investigated prevalence and correlates of help seeking and self-medication in Norwegian adults with trauma history with a focus on common posttrauma outcomes of posttraumatic stress disorder (PTSD) and substance use disorders (alcohol or drug). Participants reporting at least 1 PTSD symptom (n = 307) were asked if they consulted with a doctor/another professional (help seeking) or used drugs/alcohol (self-medication) for trauma-related problems. PTSD, alcohol abuse or dependence (AUD), and drug use or dependence (DUD) were assessed via structured diagnostic interviews. Help seeking and self-medication were endorsed by 37.4% and 10.4% of the sample, respectively. As compared to the full sample, help seeking was endorsed at a greater rate in individuals with PTSD (χ2 = 8.59, p = .005) and at a lower rate in those with AUD (χ2 = 7.34, p < .004). Self-medication was more likely to be endorsed by individuals with PTSD than without PTSD (χ2 = 25.68, p < .001). In regression analyses, PTSD was associated with increased likelihood of self-medication (odds ratio [OR] = 4.56) and help seeking (OR = 2.29), while AUD was associated with decreased likelihood of help-seeking (OR = .29). When self-medication was included as a predictor, PTSD was no longer associated with help seeking, although AUD remained inversely associated. PTSD and AUDs have a nuanced relationship with formal help seeking as well as the use of substances to cope. Trauma-exposed individuals are likely engaging in adaptive and maladaptive coping strategies, the latter of which may be compounding distress. (PsycINFO Database Record
Mental Illness Research Education and Clinical Center, Richmond Veterans Affairs Medical Center.
Christina
C
Sheerin
University of Virginia.
Erin C
EC
Berenz
Division of Mental Health, Norwegian Institute of Public Health.
Gun Peggy
GP
Knudsen
Division of Mental Health, Norwegian Institute of Public Health.
Ted
T
Reichborn-Kjennerud
Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University.
Kenneth S
KS
Kendler
Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University.
Steven H
SH
Aggen
Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University.
Ananda B
AB
Amstadter
D000223:Adaptation, Psychological; D000328:Adult; D005260:Female; D000066505:Help-Seeking Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012651:Self Medication; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy