The role of complex PTSD in mediating childhood maltreatment and substance abuse severity among youth seeking substance abuse treatment.

Abstract

Research has indicated that childhood maltreatment is associated with youth substance use problems; however, this association is not yet fully understood. Consistent with theories that describe substance use problems as reflecting impaired self-regulation abilities, we hypothesized that complex posttraumatic stress disorder (Complex PTSD), reflecting disruptions in the development of self-regulatory capacities, would mediate the association between maltreatment and substance use problem severity. Questionnaires assessing severity of drug and alcohol problems, maltreatment, and Complex PTSD symptoms were collected from 144 young men and 72 young women (N = 216) aged 16–24 years entering an outpatient substance abuse program. Results indicated the mediation model was an adequate fit to the data, χ2(49, N = 216) = 102.23, p < .001, comparative fit index = .949, Tucker-Lewis index = .932, root mean square error of approximation = .071. Complex PTSD symptoms were elevated among youth with maltreatment histories, and they partially mediated the relation between maltreatment and substance abuse (β = .21, p < .05). Because 25.3% of the variance in substance use problem severity was predicted by this model, future research expanding upon the model is recommended. The findings provide preliminary support for the development of treatment methods that address Complex PTSD among youth with maltreatment histories who abuse substances.

Developmental pathways from child maltreatment to adolescent substance use: The roles of posttraumatic stress symptoms and mother-child relationships

“…The pathways of PTS symptoms linked physical and sexual abuse to substance use. These findings corroborate past research identifying indirect effects from overall maltreatment, to PTS, to adolescent substance use (Rosenkranz et al, 2014). Consistent with past research (Pelcovitz et al, 1994; Ullman et al, 2009), physical and sexual abuse were related to higher PTS symptoms, which in turn, were related to higher substance use.…”

“…In line with the developmental traumatology theory, empirical research has suggested the potential PTS connection between childhood maltreatment and adolescent substance use (e.g., Rosenkranz, Muller, & Henderson, 2014). For example, experiencing physical abuse and sexual abuse has been related to increased risk of PTS, and PTS has been reported to be a predictor of substance use (Goldstein et al, 2011; Ullman et al, 2009).…”

“…Few studies, however, have examined PTS as a mechanism connecting maltreatment and substance use, and these studies have yielded mixed results. One study found a significant indirect pathway from overall maltreatment to adolescent substance use through complex PTS symptoms among youth seeking substance use treatment (Rosenkranz, Muller, & Henderson, 2014). ) On the contrary, another study found no significant indirect effect of maltreatment on substance use through PTS (Faulkner, Goldstein, Wekerle, 2014).…”

“Learning how to ask”: Effectiveness of a training for trauma inquiry and response in substance use disorder healthcare professionals.

“…One third of the clients with alcohol dependence reported emotional abuse; one third reported physical abuse; and one fourth reported sexual abuse (Huang et al, 2012). SUD clients that had been exposed to traumatic events present a greater addiction severity (Greenfield et al, 2002;Lown, Nayak, Korcha, & Greenfield, 2011;Rosenkranz, Muller, & Henderson, 2014), more comorbid mental disorders (Evren, Kural, & Cakmak, 2006;Kessler et al, 1997) and greater somatic health problems (Kang, Deren, & Goldstein, 2002;Ouimette, Moos, & Finney, 2000) than SUD clients without trauma exposure. As a result, SUD clients exposed to traumatic events relapse earlier (Farley, Golding, Young, Mulligan, & Minkoff, 2004;Greenfield et al, 2002;Walitzer & Dearing, 2006) and have a higher risk of dropout from treatment (Hien & Levin, 1994;Jaycox, Ebener, Damesek, & Becker, 2004;Thompson & Kingree, 1998).…”

Current Psychosocial Treatment Options for PTSD among Youth

“…Without adequate intervention, the long-term personal, social, and economic costs associated with childhood PTSD are exceptionally high. For example, adults with PTSD who experienced their first trauma prior to puberty are more likely to (a) develop severe depressive symptoms, (b) attempt suicide, (c) be hospitalized for a myriad of psychiatric disorders, and/ or (d) engage in substance abuse [4,5]. In addition, PTSD is also a significant predictor or impaired selfregulation abilities.…”