Relations between posttraumatic stress symptom dimensions and substance dependence in a community-recruited sample of substance-abusing women.

Abstract

The factor structure of posttraumatic stress disorder (PTSD) symptoms, and correlations between PTSD dimensions and substance dependence, were examined in 295 substance-abusing women. Participants completed self-report measures of trauma exposure, PTSD symptoms, and alcohol dependence and underwent interviews regarding dependence on prescription anxiolytics and analgesics. Overall, PTSD symptoms were moderate in intensity, and 46% of the sample met criteria for PTSD diagnoses. A principal-components analysis on PTSD item scores revealed a correlated 4-factor solution (i.e., Intrusions, Arousal, Numbing, and Avoidance factors). Alcohol dependence correlated with PTSD Arousal scores, anxiolytic dependence with Arousal and Numbing scores, and analgesic dependence with Arousal, Intrusions, and Numbing scores. Implications for understanding functional relations between PTSD and substance use disorders are discussed, as are suggestions for intervention with comorbid patients.Posttraumatic stress disorder (PTSD) is an DSM-IV; American Psychiatric Association anxiety disorder that can emerge after exposure [APA], 1994). In both the revised third edition to a traumatic stressor (i.e., when a person is (DSM-1II-R; APA, 1987 and DSM-IV definiconfronted with, experiences, or witnesses an tionsofPTSD, 17 symptoms are organized into event involving actual or threatened death or three clusters: Criterion B-Intrusions (e.g., serious injury, or a threat to the physical nightmares); Criterion C-Avoidance/Numbing integrity of the self or others, and when the (e.g., avoidance of trauma reminders; feelings of person's response involves intense helplessness, detachment); and Criterion D-Arousal (e.g., fear, or horror; Criterion A, Diagnostic and Stat-exaggerated startle). istical Manual of Mental Disorders (4th ed.;There is, however, considerable controversy

Alcohol problems and posttraumatic stress disorder in female crime victims

“…Several studies have found PTSD increases risk of first onset of AUD in women Stewart et al, 1999) (Brady, Back, & Coffey, 2004;Stewart, 1996). Other studies have found AUD may increase risk of development of PTSD or be associated with a more severe and chronic course of symptoms (Acierno et al, 1999;Conrod & Stewart, 2003;Cottler et al, 1992).…”

“…AUDs have been associated with more severe PTSD symptoms, such as elevated avoidance and hyperarousal symptoms (Back, Sonne, Killeen, Dansky, & Brady, 2003;Stewart, Conrod, Pihl, & Dongier, 1999) and more reexperiencing symptoms (Read, Brown, & Kahler, 2004).…”

The structure of post-traumatic stress disorder symptoms in three female trauma samples: A comparison of interview and self-report measures

“…In most cases authors are permitted to post their version of the article (e.g. (Foa, Zinbarg, & Rothbaum, 1992), and may bear different functional relationships with interpersonal functioning, with physical health, and with symptoms often found co-morbid with post-traumatic stress symptoms (Kimerling, Clum, & Wolfe, 2000;Ruscio, Weathers, King, & King, 2002;Stewart, Conrod, Pihl, & Dongier, 1999;Stewart, Pihl, Conrod, & Dongier, 1998). Thus, a clear understanding of the nature of PTSD symptom clusters has the potential to inform both knowledge of how various PTSD symptoms develop and how these symptoms relate to co-occurring difficulties.…”

“…Initial factor analyses of PTSD symptoms were exploratory in nature; direct testing of hypotheses regarding the nature of these symptoms is not possible with such analyses. To date, exploratory factor analyses of DSM-III-R/DSM-IV PTSD symptoms have been conducted with numerous populations, including survivors of fires, motor vehicle accidents and assaults, United Nations peacekeepers, refugees, and military veterans (Fawzi et al, 1997;Foa, Riggs, & Gershuny, 1995;Keane, 1993;Maes et al, 1998aMaes et al, , 1998bSack, Seeley, & Clarke, 1997;Shelby, Golden-Kreutz, & Andersen, 2005;Smith, Redd, DuHamel, Vickberg, & Ricketts, 1999;Smith, Perrin, Dyregrov, & Yule, 2003;Stewart et al, 1999;Taylor, Kuch, Koch, Crockett, & Passey, 1998). Two-, three-, four-, and five-factor solutions have been reported, with no solution clearly paralleling the symptom clusters suggested by the most recent versions of the DSM.…”

Effect of Self-Esteem in the Relationship between Stress and Substance Abuse among Adolescents: A Mediation Outcome

“…It can also influence illness, either through changing health-related behaviour's such as smoking or via physiological pathways [8]. Studies thus far have found a positive relationship between stress and substance abuse [9], [10] with stress mostly resulting to substance abuse. Although, most literatures reviewed found a significant and positive correlation between stress and substance abuse, however, a few studies found no relationship between the constructs [11].…”