title: The intervening role of urgency on the association between childhood maltreatment, PTSD, and substance-related problems.
abstract: A range of risk factors lead to opioid use and substance-related problems (SRP) including childhood maltreatment, elevated impulsivity, and psychopathology. These constructs are highly interrelated such that childhood maltreatment is associated with elevated impulsivity and trauma-related psychopathology such as posttraumatic stress disorder (PTSD), and impulsivity-particularly urgency-and PTSD are related. Prior work has examined the association between these constructs and substance-related problems independently and it is unclear how these multi-faceted constructs (i.e., maltreatment types and positive and negative urgency) are associated with one another and SRP. The current study used structural equation modeling (SEM) to examine the relations among childhood maltreatment, trait urgency, PTSD symptoms, and SRP in a sample of individuals with a history of opioid use. An initial model that included paths from each type of childhood maltreatment, positive and negative urgency, PTSD and SRP did not fit the data well. A pruned model with excellent fit was identified that suggested emotional abuse, positive urgency, and negative urgency were directly related to PTSD symptoms and only PTSD symptoms were directly related to SRP. Furthermore, significant indirect effects suggested that emotional abuse and negative urgency were related to SRP via PTSD symptom severity. These results suggest that PTSD plays an important role in the severity of SRP.
authors.affiliation: Center for Research on Emotion, Stress, and Technology, Department of Psychological Science, University of Vermont, United States.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Mirhashem
authors.affiliation: Center for Research on Emotion, Stress, and Technology, Department of Psychological Science, University of Vermont, United States.
authors.forename: Holley C
authors.initials: HC
authors.lastname: Allen
authors.affiliation: Department of Psychiatry, Indiana University School of Medicine, United States.
authors.forename: Zachary W
authors.initials: ZW
authors.lastname: Adams
authors.affiliation: Center for Research on Emotion, Stress, and Technology, Department of Psychological Science, University of Vermont, United States.
authors.forename: Katherine
authors.initials: K
authors.lastname: van Stolk-Cooke
authors.affiliation: Center for Research on Emotion, Stress, and Technology, Department of Psychological Science, University of Vermont, United States.
authors.forename: Alison
authors.initials: A
authors.lastname: Legrand
authors.affiliation: Center for Research on Emotion, Stress, and Technology, Department of Psychological Science, University of Vermont, United States. Electronic address: Matthew.Price@uvm.edu.
authors.forename: Matthew
authors.initials: M
authors.lastname: Price
mesh_terms: D000328:Adult; D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D009511:New England / Q000453:epidemiology; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology*; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology*
keywords: Childhood maltreatment; Opioid addiction; PTSD