Trauma, Gender, and Mental Health Symptoms in Individuals With Substance Use Disorders

Abstract

Individuals with substance use disorders are often plagued by psychiatric comorbidities and histories of physical and/or sexual trauma. Males and females, although different in their rates of expressed trauma and psychiatric symptomatology, experience comparable adverse consequences, including poorer substance abuse treatment outcomes, diminished psychosocial functioning, and severe employment problems. The goal of the current study was to examine the relationships between trauma history, lifetime endorsement of psychiatric symptoms, and gender in a sample of individuals participating in outpatient substance abuse treatment. Study participants ( N = 625) from six psychosocial counseling and five methadone maintenance programs were recruited as part of a larger study conducted through the National Institute on Drug Abuse Clinical Trials Network (NIDA CTN). Study measures included lifetime trauma experience (yes/no), type of trauma experienced (sexual, physical, both), lifetime depression/anxiety, and lifetime suicidal thoughts/attempts (as measured by the Addiction Severity Index–Lite [ ASI-Lite]). Lifetime endorsement of psychiatric symptoms was compared between individuals with and without trauma history. The role of gender was also examined. Results indicated that the experience of trauma was associated with an increase in lifetime report of psychiatric symptoms. Experience of physical and combined physical and sexual trauma consistently predicted positive report of psychiatric symptoms in both males and females, even when controlling for demographic and treatment-related variables. Employment outcomes, however, were not predicted by self-reported history of lifetime trauma.

Gender Considerations in Addiction: Implications for Treatment

“…A multi-site clinical trial of the Job Seekers’ Workshop (JSW) found women in outpatient SUD treatment reported higher rates of physical and sexual abuse as well as suicidality than men (40). Severity of mental health symptoms, however, did not differ by gender and lifetime trauma did not predict employment outcomes.…”

Trauma Symptoms for Men and Women in Substance Abuse Treatment: A Latent Transition Analysis

“…Women are more likely to report a history of sexual and physical abuse and trauma-related symptoms than are men although both men and women who have experienced abuse are more likely to report psychiatric symptoms than are men and women who have not experienced abuse (Keyser-Marcus et al, 2014). In their review of research on gender, traumatic experiences and trauma symptoms, Tolin and Foa (2006) reported differences between men and women in both the types of traumatic experiences commonly reported and the symptoms expressed in response to those experiences.…”

Traumatic Experiences in Childhood and Adult Substance Use in a Nonclinical Sample: The Mediating Role of Arousal/Reactivity

“…Socioeconomic status was included to account for variance by income level, based on previous research that indicates higher SES decreases substance use due to increased locus of control (Elliott & Lowman, 2015), whereas lower SES is frequently associated with increased exposure to traumatic events (Brewin et al, 2000). Gender was included due to previous studies that reveal gender differences among adults with histories of childhood trauma and their use of alcohol or other drugs (Evans, Upchurch, Simpson, Hamilton, & Hoggatt, 2018;Keyser-Marcus et al, 2014). Participant age was recorded by participants entering their age in years, and was included based on previous research that indicates alcohol and illicit drug use typically decreases as individuals age (Chen & Kandel, 1995).…”