title: PTSD Symptom Severities, Interpersonal Traumas, and Benzodiazepines Are Associated with Substance-Related Problems in Trauma Patients.
abstract: BACKGROUND
  Trauma is commonly associated with substance-related problems, yet associations between specific substances and specific posttraumatic stress disorder symptoms (PTSSs) are understudied. We hypothesized that substance-related problems are associated with PTSS severities, interpersonal traumas, and benzodiazepine prescriptions.
  
  
  METHODS
  Using a cross-sectional survey methodology in a consecutive sample of adult outpatients with trauma histories (n = 472), we used logistic regression to examine substance-related problems in general (primary, confirmatory analysis), as well as alcohol, tobacco, and illicit drug problems specifically (secondary, exploratory analyses) in relation to demographics, trauma type, PTSSs, and benzodiazepine prescriptions.
  
  
  RESULTS
  After adjusting for multiple testing, several factors were significantly associated with substance-related problems, particularly benzodiazepines (AOR = 2.78; 1.99 for alcohol, 2.42 for tobacco, 8.02 for illicit drugs), DSM-5 PTSD diagnosis (AOR = 1.92; 2.38 for alcohol, 2.00 for tobacco, 2.14 for illicit drugs), most PTSSs (especially negative beliefs, recklessness, and avoidance), and interpersonal traumas (e.g., assaults and child abuse).
  
  
  CONCLUSIONS
  In this clinical sample, there were consistent and strong associations between several trauma-related variables and substance-related problems, consistent with our hypotheses. We discuss possible explanations and implications of these findings, which we hope will stimulate further research, and improve screening and treatment.
authors: Wright-Patterson Medical Center, Wright-Patterson Air Force Base, OH 45433, USA. jeffrey.guina@wright.edu.|Wright State University Boonshoft School of Medicine, Dayton, OH 45469, USA. jeffrey.guina@wright.edu.
authors: Jeffrey
authors: J
authors: Guina
authors: Wright State University Boonshoft School of Medicine, Dayton, OH 45469, USA. ramzi.nahhas@wright.edu.
authors: Ramzi W
authors: RW
authors: Nahhas
authors: Wright State University Boonshoft School of Medicine, Dayton, OH 45469, USA. goldberg.6@wright.edu.
authors: Adam J
authors: AJ
authors: Goldberg
authors: Misawa Air Base Medical Center, Misawa Air Base, Japan. seth.farnsworth@gmail.com.
authors: Seth
authors: S
authors: Farnsworth
keywords: PTSD; alcohol; drugs; nicotine; stress disorder; substance use; tobacco; trauma