A clinical profile of women with posttraumatic stress disorder and substance dependence.

Abstract

To assess the clinical characteristics of women with posttraumatic stress disorder (PTSD) and substance dependence, 28 women with both disorders were compared with 29 women with PTSD alone on a wide battery of lifetime and current clinical measures. The dual-diagnosis women consistently had a more severe clinical profile, including worse life conditions (e.g., physical appearance, opportunities in life), both as children and as adults; greater criminal behavior; a higher number of lifetime suicide attempts; a greater number having a sibling with a drug problem; and fewer outpatient psychiatric treatments. One discrepant finding, however, was their lower rate of major depression. Interestingly, the 2 groups did not differ in number or type of lifetime traumas, PTSD onset or severity, family history of substance use; coping style, functioning level, psychiatric symptoms, or sociodemographic characteristics. Treatment implications and methodological limitations are discussed.To date, there is only limited understanding of the factors that contribute to the high concordance between posttraumatic stress disorder (PTSD) and substance use disorder, particularly for women. One finding is that women's trauma profile is associated with substance use disorders. Specifically, women with this dual diagnosis typically have a history of childhood physical or sexual abuse, often repetitive and by family members (

Posttraumatic Stress Disorder, Health Problems, and Depression Among African American Women in Residential Substance Use Treatment

“…5,12,60 Scores for all nine primary dimensions of the BSI as well as the General Symptom Severity Index were significantly higher in SUD women with comorbid PTSD compared to those without PTSD. These findings are congruent with existing literature showing more severe clinical profiles and interpersonal problems in dually diagnosed females compared to females with only one of the two disorders 3,61,62 and call for improved assessment and treatment within this population.…”

Alcohol dependence and posttraumatic stress disorder: differences in clinical presentation and response to cognitive–behavioral therapy by order of onset

“…The rates found in these other studies may be higher because some samples included individuals with drug dependence, which typically begins at a later age than AD, and some were comprised of only women. Similar to the findings of the current study, higher rates of primary PTSD are more often found among women than among men Kessler et al, 1997;Najavits et al, 1999).…”

“…Findings from other studies, including both community and treatment-seeking samples, estimate that PTSD is primary in approximately 65% to 84% of cases among SUD-PTSD individuals (Epstein et al, 1998;Kessler et al, 1997;Najavits et al, 1999). The rates found in these other studies may be higher because some samples included individuals with drug dependence, which typically begins at a later age than AD, and some were comprised of only women.…”

“…Data from a national probability household sample of adult women in the United States (Epstein, Saunders, Kilpatrick, & Resnick, 1998) revealed that 65% reported the onset of first PTSD symptom before the onset of their first alcohol-abuse symptoms. In another study of treatment-seeking women with PTSD and SUDs, Najavits, Weiss, and Shaw (1999) reported that 60.7% of women experienced the onset of PTSD before the onset of their SUD.…”

Validation of the Primary Care Posttraumatic Stress Disorder screening questionnaire (PC-PTSD) in civilian substance use disorder patients

“…The high comorbidity between SUD and PTSD has important clinical implications. Compared to individuals with either disorder alone, patients with comorbid SUD and PTSD show more severe symptoms and worse treatment outcome (Back et al, 2000;Brown & Wolfe, 1994;Najavits, Weiss, & Shaw, 1999;Ouimette, Brown, & Najavits, 1998). It has been suggested that the treatment effects for this patient group can be improved by providing a combined treatment program for SUD and PTSD (Donovan, Padin-Rivera, & Kowaliw, 2001;Driessen et al, 2008;McGovern et al, 2009;Najavits et al, 2007;Rash, Coffey, Baschnagel, Drobes, & Saladin, 2008).…”