title: Drinking to ease the burden: a cross-sectional study on trauma, alcohol abuse and psychopathology in a post-conflict context.
abstract: It is likely that alcohol use and abuse increase during and after violent conflicts. The most prominent explanation of this phenomenon has been referred to as self-medication hypothesis. It predicts that psychotropic substances are consumed to deal with conflict-related psychic strains and trauma. In northern Uganda, a region that has been affected by a devastating civil war and is characterized by high levels of alcohol abuse we examined the associations between war-trauma, childhood maltreatment and problems related to alcohol use. Deducing from the self-medication hypothesis we assumed alcohol consumption moderates the relationship between trauma-exposure and psychopathology.
  
  
  
  A cross-sectional epidemiological survey targeting war-affected families in post-conflict northern Uganda included data of male (n = 304) and female (n = 365) guardians. We used standardized questionnaires in an interview format to collect data on the guardians' socio-demography, trauma-exposure, alcohol consumption and symptoms of alcohol abuse, PTSD and depression.
  
  
  
  Symptoms of current alcohol use disorders were present in 46 % of the male and 1 % of the female respondents. A multiple regression model revealed the unique contributions of emotional abuse in the families of origin and trauma experienced outside the family-context in the prediction of men's alcohol-related symptoms. We found that alcohol consumption moderated the dose-effect relationship between trauma-exposure and symptoms of depression and PTSD. Significant interactions indicated that men who reported more alcohol-related problems experienced less increase in symptoms of PTSD and depression with increasing trauma-exposure.
  
  
  
  The gradual attenuation of the dose-effect the more alcohol-related problems were reported is consistent with the self-medication hypothesis. Hence, the functionality of alcohol consumption has to be considered when designing and implementing addiction treatment in post-conflict contexts.
authors.affiliation: Clinical Psychology and Psychotherapy, Department of Psychology, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany. verena.ertl@uni-bielefeld.de.|vivo international, Konstanz, Germany. verena.ertl@uni-bielefeld.de.|Clinical Psychology and Psychotherapy, Department of Psychology, Bielefeld University, P.O. Box 100131, 33501, Bielefeld, Germany. verena.ertl@uni-bielefeld.de.
authors.forename: Verena
authors.initials: V
authors.lastname: Ertl
authors.affiliation: Clinical Psychology and Psychotherapy, Department of Psychology, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany.|vivo international, Konstanz, Germany.
authors.forename: Regina
authors.initials: R
authors.lastname: Saile
authors.affiliation: Clinical Psychology and Psychotherapy, Department of Psychology, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany.|vivo international, Konstanz, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Neuner
authors.affiliation: Clinical Psychology and Psychotherapy, Department of Psychology, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany.|vivo international, Konstanz, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Catani
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology*; D019973:Alcohol-Related Disorders / Q000523:psychology; D000437:Alcoholism / Q000523:psychology*; D000068337:Armed Conflicts / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D000069581:Exposure to Violence / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011599:Psychopathology; D011619:Psychotropic Drugs; D012651:Self Medication / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D011795:Surveys and Questionnaires; D014454:Uganda
chemical_list: D011619:Psychotropic Drugs
keywords: Addiction; Alcohol; Conflict; Depression; Mental health; PTSD; Self-medication; Substance abuse; Trauma; War