Physical and sexual abuse history and addiction treatment outcomes.

Rosen, Craig S.; Ouimette, Paige; Sheikh, Javaid I.; Gregg, Jennifer; Moos, Rudolf H.

doi:10.15288/jsa.2002.63.683

Cited by 80 publications

(86 citation statements)

References 16 publications

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“…Other research indicates that drug treatment is more effective when providers address issues related to childhood and adult physical and sexual abuse. 27,32,33 Economic vulnerability also appears to be an important part of women's inability to maintain injection cessation, since women earning less money had a shorter time to relapse. Research shows that socioeconomic conditions often underlie entry into sex work and that economic vulnerability can increase HIV-related risks by reducing women's negotiating power with clients and increasing unprotected sex in exchange for more money.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Injection Cessation and Relapse among Female Sex Workers who Inject Drugs in Two Mexican-US Border Cities

et al. 2015

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We know little about predictors of injection drug cessation and relapse among female sex workers who inject drugs (FSW-PWID) at the US-Mexico border. Among HIV-negative FSW-PWID taking part in a behavioral intervention study in Tijuana and Ciudad Juárez, Cox regression was used to identify predictors of time to first cessation of injection, which was defined as reporting not having injected drugs for a period of 4 months or longer, and among that subset, we examined predictors of time to injection relapse. Among 440 women, 84 (19 %) reported ceasing injection during follow-up (median time to cessation = 9.3 months); of these, 30 (35 %) reported relapse to injection (median time to relapse = 3.5 months). The rate of injection cessation was lower for women reporting trading sex prior to age 18 (adj. hazard ratio (HR) = 0.64, 95 % confidence interval (CI) = 0.41-1.01), ever being sexually abused (adj. HR = 0.44, 95 % CI = 0.27-0.71), and a higher number of vaginal sex acts with casual clients (adj. HR = 0.99 per transaction, 95 % CI = 0.98-1.00). The rate of cessation was higher for women who spent more hours on the streets on a typical day (adj. HR = 1.04/h, 95 % CI = 1.01-1.08) and who lived in Tijuana vs. Ciudad Juárez (adj. HR = 2.15, 95 % CI = 1.14-4.07). The rate of relapse was higher among women reporting regular drug use with clients (adj. HR = 2.17, 95 % CI = 0.96-4.89) and those scoring higher on a risk injection index (adj. HR = 2.04, 95 % CI = 1.15-3.61). The rate of relapse was lower for FSW-PWID with higher than average incomes (adj. HR = 0.40, 95 % CI = 0.18-0.89). These findings have important implications for the scale-up of methadone maintenance treatment programs (MMTPs) in Mexico and indicate a need for gender-specific programs that address sexual abuse experiences and economic vulnerabilities faced by FSW-PWID.

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Section: Discussionmentioning

confidence: 99%

Predictors of Injection Cessation and Relapse among Female Sex Workers who Inject Drugs in Two Mexican-US Border Cities

et al. 2015

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“…Moreover, patients with substance abuse reporting childhood trauma show more psychopathological symptoms [18,19] , have a higher consumption of substances [20] and a higher rate of relapse [21] . Similar characteristics of the course and outcome of substance use disorders have been linked to dysregulation of the HPA axis in humans [22][23][24] , and animal studies suggest that a higher degree of substance intake is related to increased activity of the HPA axis [3,15,25] .…”

Section: Introductionmentioning

confidence: 99%

Impact of Childhood Trauma on Hypothalamus-Pituitary-Adrenal Axis Activity in Alcohol-Dependent Patients

Schäfer¹,

Teske²,

Schulze-Thüsing³

et al. 2010

Eur Addict Res

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Aims: Studies in animals and humans suggest that early life stress alters hypothalamus-pituitary-adrenal (HPA) axis activity. The same alterations are related to the symptoms and course of alcohol dependence. This study examined relationships between childhood trauma and HPA axis activity in alcohol-dependent patients controlling for psychopathology and characteristics of dependence. Methods: Thirty-eight consecutive patients (42% female) were examined at admission to detoxification (t1) and 14 days later (t2). Morning plasma levels of cortisol and adrenocorticotropin-releasing hormone (ACTH) were determined. Participants completed the Childhood Trauma Questionnaire (CTQ) and measures of anxiety, depression, and posttraumatic stress disorder. Results: Sexual abuse was related to higher levels of cortisol during acute withdrawal (r = 0.38, p = 0.02). Levels of ACTH were negatively correlated with the CTQ total score (t2: r = –0.42, p < 0.01), emotional abuse (t2: r = –0.33, p = 0.04), emotional neglect (t2: r = –0.33, p = 0.04), and physical neglect (t2: r = –0.33, p = 0.05) controlling for psychopathology and characteristics of dependence. Conclusions: Our findings suggest, that childhood trauma is related to blunted ACTH and increased cortisol during withdrawal in alcohol-dependent patients. Early life stress might be a confounding variable in studies of HPA function in alcohol dependence and future studies should examine potential clinical consequences of these relationships.

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“…The experience of trauma alone adversely affects treatment outcome from mental health services (Ouimette, Moos, & Finney, 2000;Rosen, Ouimette, Sheikh, Gregg, & Moos, 2002). For individuals with sexual trauma, sharing their abusive experiences can be particularly challenging for a variety of reasons, including: lack of trust in self and others (Finkelhor & Browne, 1985), lack of support in overcoming the distress associated with recall of trauma (Valentine & Feinauer, 1993), and lack of perceived benefit in recalling the past (Himelein & McElrath, 1996).…”

Section: Introductionmentioning

confidence: 99%

Outcomes from a Group Intervention for Coping with HIV/AIDS and Childhood Sexual Abuse: Reductions in Traumatic Stress

et al. 2006

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Childhood sexual abuse is common among HIV-infected persons, though few empirically supported treatments addressing sexual abuse are available for men and women with HIV/AIDS. This study reports the outcome from a randomized controlled trial of a group intervention for coping with HIV and sexual abuse. A diverse sample of 202 HIV-positive men and women who were sexually abused as children was randomly assigned to one of three conditions: a 15-session HIV and trauma coping group intervention, a 15-session support group comparison condition, or a waitlist control (later randomly assigned to an intervention condition). Traumatic stress symptoms were assessed at baseline and post-intervention, with analysis conducted for the three-condition comparison followed by analysis of the two-condition comparison between the coping and support group interventions. Participants in the coping group intervention exhibited reductions in intrusive traumatic stress symptoms compared to the waitlist condition and in avoidant traumatic stress symptoms compared to the support group condition. No differences were found between the support group intervention and waitlist conditions. Tests of clinical significance documented the meaningfulness of change in symptoms.

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Physical and sexual abuse history and addiction treatment outcomes.

Cited by 80 publications

References 16 publications

Predictors of Injection Cessation and Relapse among Female Sex Workers who Inject Drugs in Two Mexican-US Border Cities

Predictors of Injection Cessation and Relapse among Female Sex Workers who Inject Drugs in Two Mexican-US Border Cities

Impact of Childhood Trauma on Hypothalamus-Pituitary-Adrenal Axis Activity in Alcohol-Dependent Patients

Outcomes from a Group Intervention for Coping with HIV/AIDS and Childhood Sexual Abuse: Reductions in Traumatic Stress

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