Substance use, childhood traumatic experience, and Posttraumatic Stress Disorder in an urban civilian population

• Type of Material: Article
• Authors: Lamya Khoury, Emory University; Yilang Tang, Emory University; Bekh Bradley-Davino, Emory University; Joseph F Cubells, Emory University; Kerry Ressler, Emory University
• Language: English
• Date: 2010-11-03
• Publisher: Wiley-Blackwell
• Publication Version: Final Published Version
• Copyright Statement: © 2010 Wiley-Liss, Inc.
• License: Creative Commons Attribution-NonCommercial 2.5 Generic
• Final Published Version (URL): http://onlinelibrary.wiley.com/doi/10.1002/da.20751/abstract;jsessionid=77B10E7CB601D56533BC8C47096B5C38.f01t04
• Title of Journal or Parent Work: Depression and Anxiety
• ISSN: 1091-4269
• Volume: 27
• Issue: 12
• Start Page: 1077
• End Page: 1086
• Grant/Funding Information: This work was primarily supported by National Institutes of Mental Health (MH071537). Support was also received from National Institute of Mental Health (MH082256 to CFG), National Institute of Drug Abuse (DA015766 to JFC), Emory and Grady Memorial Hospital General Clinical Research Center, NIH National Centers for Research Resources (M01RR00039), the American Foundation for Suicide Prevention (RGB) and the Burroughs Wellcome Fund (KJR).
• Keywords: minority; alcohol; opiate; psychiatry; childhood maltreatment; Marijuana; African-American; cocaine; trauma
• Research Categories: Psychology, Behavioral; Psychology, General

Abstract

Objective: Exposure to traumatic experiences, especially those occurring in childhood, has been linked to substance use disorders (SUDs), including abuse and dependence. SUDs are also highly comorbid with Posttraumatic Stress Disorder (PTSD) and other mood-related psychopathology. Most studies examining the relationship between PTSD and SUDs have examined veteran populations or patients in substance treatment programs. The present study further examines this relationship between childhood trauma, substance use, and PTSD in a sample of urban primary care patients. Method: There were 587 participants included in this study, all recruited from medical and OB/GYN clinic waiting rooms at Grady Memorial Hospital in Atlanta, GA. Data were collected through both screening interviews as well as follow-up interviews. Results: In this highly traumatized population, high rates of lifetime dependence on various substances were found (39% alcohol, 34.1% cocaine, 6.2% heroin/opiates, and 44.8% marijuana). The level of substance use, particularly cocaine, strongly correlated with levels of childhood physical, sexual, and emotional abuse as well as current PTSD symptoms. In particular, there was a significant additive effect of number of types of childhood trauma experienced with history of cocaine dependence in predicting current PTSD symptoms, and this effect was independent of exposure to adult trauma. Conclusions: These data show strong links between childhood traumatization and SUDs, and their joint associations with PTSD outcome. They suggest that enhanced awareness of PTSD and substance abuse comorbidity in high-risk, impoverished populations is critical to understanding the mechanisms of substance addiction as well as in improving prevention and treatment.