Ptsd and substance use disorders among adolescents: Self-stigma and gender perspective
DOI:
https://doi.org/10.21134/999Keywords:
trauma, adolescents, self-stigma, substance use disorders, gender perspectiveAbstract
After a traumatic event, people may have a variety of reactions. Most people will outgrow these symptoms, but some may continue to have them over time, and meet criteria for a diagnosis of post-traumatic stress disorder (PTSD).
PTSD, by definition, is a problem of emotional and behavioural regulation. There are intrusive memories (or flashbacks) that the person tries to avoid (or dissociate), with an increase in hypervigilance and reactivity to stimuli reminiscent of the trauma, as well as cognitive symptoms and mood alterations. In terms of gender, the diagnosis of PTSD has been associated 2-3 times more often with females, due to physiological regulation as well as social and psychological factors (Olff, 2017).
The poorly adaptive strategies that the person adopts to cope with stress involve emotional dysregulation, which is closely related to the presence of mental health problems and addictions, as recently developed by Latorre (2024) in an editorial in this journal.
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Adams, Z. W., Hahn, A. M., McCart, M. R., Chapman, J. E., Sheidow, A. J., Walker, J., de Arellano, M., & Danielson, C. K. (2021). Predictors of substance use in a clinical sample of youth seeking treatment for Trauma-
related mental health problems. Addictive behaviors, 114, 106742. https://doi.org/10.1016/ j.addbeh.2020.106742
Basedow, L. A., Wiedmann, M. F., Roessner, V., Golub, Y., & Kuitunen-Paul, S. (2022). Coping motives
mediate the relationship between PTSD and MDMA use in adolescents with substance use disorders. Addiction science & clinical practice, 17(1), 46. https://doi.org/10.1186/s13722-022-00329-y
Benfer, N., Howell, M. K., Lucksted, A., Romero, E. G., & Drapalski, A. L. (2023). Self-Stigma and PTSD: Conceptualization and Implications for Research and Treatment. Psychiatric services (Washington, D.C.), 74(10), 1081–1083. https://doi.org/10.1176/appi.ps.20220397
Berenz, E. C., Edalatian Zakeri, S., Demos, A. P., Paltell, K. C., Bing-Canar, H., Kevorkian, S., & Ranney, R. (2021). Negative affect and alcohol craving in trauma-exposed young adult drinkers. Alcoholism, clinical and experimental research, 45(7), 1479–1493. https://doi.org/10.1111/acer.14641
Blakey, S. M., Yi, J. Y., Calhoun, P. S., Beckham, J. C., & Elbogen, E. B. (2019). Why do trauma survivors become depressed? Testing the behavioral model of depression in a nationally representative sample. Psychiatry research, 272, 587–594. https://doi.org/10.1016/j.psychres.2018.12.150
Blanco, L., Sió, A., Hogg, B., Esteve, R., Radua, J., Solanes, A., Gardoki-Souto, I., Sauras, R., Farré, A., Castillo, C., Valiente-Gómez, A., Pérez, V., Torrens, M., Amann, B. L., & Moreno-Alcázar, A. (2020). Traumatic Events in Dual Disorders: Prevalence and Clinical Characteristics. Journal of clinical medicine, 9(8), 2553. https:// doi.org/10.3390/jcm9082553
Bonfils, K. A., Lysaker, P. H., Yanos, P. T., Siegel, A., Leonhardt, B. L., James, A. V., Brustuen, B., Luedtke, B., & Davis, L. W. (2018). Self-stigma in PTSD: Prevalence and correlates. Psychiatry research, 265, 7–12. https:// doi.org/10.1016/j.psychres.2018.04.004
Bremer-Landau, J. D., & Caskie, G. I. L. (2019). Gender as Potential Moderator of Associations Among Trauma Exposure, Posttraumatic Stress Disorder Symptoms, and Alcohol Use Disorder Symptoms in Young Adults.
Journal of traumatic stress, 32(4), 586–594. https://doi.org/10.1002/jts.22419
Danielson, C. K., Adams, Z., McCart, M. R., Chapman, J. E., Sheidow, A. J., Walker, J., Smalling, A., & de Arellano, M. A. (2020). Safety and Efficacy of Exposure-Based Risk Reduction Through Family Therapy for Co- occurring Substance Use Problems and Posttraumatic Stress Disorder Symptoms Among Adolescents: A Randomized Clinical Trial. JAMA psychiatry, 77(6), 574–586. https://doi.org/10.1001/jamapsychiatry.2019.4803
Davis, J. P., Dworkin, E. R., Helton, J., Prindle, J., Patel, S., Dumas, T. M., & Miller, S. (2019). Extending poly- victimization theory: Differential effects of adolescents' experiences of victimization on substance use disorder diagnoses upon treatment entry. Child abuse & neglect, 89, 165–177. https://doi.org/10.1016/j.chiabu.2019.01.009
Davis, J. P., Christie, N. C., Dworkin, E. R., Prindle, J., Dumas, T. M., DiGuiseppi, G., Helton, J. J., & Ring, C. (2020). Influences of victimization and comorbid conditions on latency to illicit drug use among adolescents and young adults. Drug and alcohol dependence, 206, 107721. https://doi.org/10.1016/ j.drugalcdep.2019.107721
DiGuiseppi, G. T., Ring, C. R., Rice, E. R., & Davis, J. P. (2022). Sex differences in poly-victimization among youth experiencing homelessness prior to substance use treatment. Child abuse & neglect, 129, 105670. https:// doi.org/10.1016/j.chiabu.2022.105670
Ellenbogen, S., Colin-Vezina, D., Sinha, V., Chabot, M., & Wells, S. J. R. (2018). Contrasting mental health correlates of physical and sexual abuse-related shame. Journal of child and adolescent mental health, 30(2), 87–97. https://doi.org/10.2989/17280583.2018.1485569
Freeman, T. E., Jordan, H. R., & Madson, M. B. (2020). Coping Styles Mediate the Association between Posttraumatic Stress Disorder Symptoms and Alcohol Outcomes in College Students. Substance use & misuse, 55(14), 2371–2378. https://doi.org/10.1080/10826084.2020.1817083
Hahn, A. M., Adams, Z. W., Chapman, J., McCart, M. R., Sheidow, A. J., de Arellano, M. A., & Danielson, C. K.
(2020). Risk reduction through family therapy (RRFT): Protocol of a randomized controlled efficacy trial of
Health and Addictions / Salud y Drogas. Vol. 24 (2) 1-8 2024.
an integrative treatment for co-occurring substance use problems and posttraumatic stress disorder symptoms in adolescents who have experienced interpersonal violence and other traumatic events. Contemporary clinical trials, 93, 106012. https://doi.org/10.1016/j.cct.2020.106012
Hawn, S. E., Bountress, K. E., Sheerin, C. M., Dick, D. M., & Amstadter, A. B. (2020). Trauma-related drinking to cope: A novel approach to the self-medication model. Psychology of addictive behaviors: journal of the Society of Psychologists in Addictive Behaviors, 34(3), 465–476. https://doi.org/10.1037/adb0000552
Jordan, H. R., Madson, M. B., Nicholson, B. C., Bravo, A. J., Pearson, M. R., & Protective Strategies Study Team (2019). Posttraumatic stress disorder symptoms and problematic alcohol use in college students: The moderating role of alcohol protective behavioral strategies and gender. Psychological trauma: theory, research, practice and policy, 11(3), 247–255. https://doi.org/10.1037/tra0000417
Jordan, H. R., Madson, M. B., Bravo, A. J., Pearson, M. R., & Protective Strategies Study Team (2020). Post- traumatic stress and marijuana outcomes: The mediating role of marijuana protective behavioral strategies. Substance abuse, 41(3), 375–381. https://doi.org/10.1080/08897077.2019.1635965
Latorre, J. M. (2024). Regulación emocional: un nuevo desafío en la comprensión y el tratamiento de las adicciones. Health and Addictions/Salud Y Drogas, 24(1), 1–8. https://doi.org/10.21134/haaj.v24i1.954
Lee, J. Y., Brook, J. S., Finch, S. J., Kim, W., & Brook, D. W. (2019). Single and dual diagnoses of major depressive disorder and posttraumatic stress disorder predicted by triple comorbid trajectories of tobacco, alcohol, and marijuana use among urban adults. Substance abuse, 40(2), 221–228. https://doi.org/10.1080/08897077.2019.1572047
Melchior, H., Hüsing, P., Grundmann, J., Lotzin, A., Hiller, P., Pan, Y., Driessen, M., Scherbaum, N., Schneider, B., Hillemacher, T., Stolzenburg, S., Schomerus, G., Schäfer, I., & Cansas Study Group (2019). Substance Abuse- Related Self-Stigma in Women with Substance Use Disorder and Comorbid Posttraumatic Stress Disorder.
European addiction research, 25(1), 20–29. https://doi.org/10.1159/000496113
Mills, K. L., Barrett, E., Back, S. E., Cobham, V. E., Bendall, S., Perrin, S., Brady, K. T., Ross, J., Peach, N., Kihas, I., Cassar, J., Schollar-Root, O., & Teesson, M. (2020). Randomised controlled trial of integrated trauma-focused psychotherapy for traumatic stress and substance use among adolescents: trial protocol. BMJ open, 10(11), e043742. https://doi.org/10.1136/bmjopen-2020-043742
Moreland, A. D., Walsh, K., Hartley, C., Hanson, R., Danielson, C. K., Saunders, B., & Kilpatrick, D. G. (2018). Investigating Longitudinal Associations Between Sexual Assault, Substance Use, and Delinquency Among Female Adolescents: Results From a Nationally Representative Sample. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 63(3), 320–326. https://doi.org/10.1016/j.jadohealth.2018.04.002
Narvaez, J. C. M., Remy, L., Bermudez, M. B., Scherer, J. N., Ornell, F., Surratt, H., Kurtz, S. P., & Pechansky, F. (2019). Re-traumatization Cycle: Sexual Abuse, Post-Traumatic Stress Disorder and Sexual Risk Behaviors among Club Drug Users. Substance use & misuse, 54(9), 1499–1508. https://doi.org/10.1080/10826084.2019.1589521
Olff, M. (2017). Sex and gender differences in post-traumatic stress disorder: an update. European Journal of Psychotraumatology, 8(sup4), 1351204. https://doi.org/10.1080/20008198.2017.1351204
Organización Mundial de la Salud. (2019). Clasificación estadística internacional de enfermedades y problemas de salud relacionados (11ª ed.). https://icd.who.int/
Pahl, K., Williams, S. Z., Lee, J. Y., Joseph, A., & Blau, C. (2020). Trajectories of violent victimization predicting PTSD and comorbidities among urban ethnic/racial minorities. Journal of consulting and clinical psychology, 88(1), 39–47. https://doi.org/10.1037/ccp0000449
Paltell, K. C., Smith, R. L., Kansky, J., Cox, C. M., Amstadter, A. B., Dick, D., The Spit For Science Working Group, Salvatore, J. E., & Berenz, E. C. (2020). Posttraumatic stress disorder symptoms, relationship quality, and risky alcohol use among trauma-exposed students. Addictive behaviors, 102, 106216. https://doi.org/10.1016/j.addbeh.2019.106216
Park, T., Thompson, K., Wekerle, C., Al-Hamdani, M., Smith, S., Hudson, A., Goldstein, A., & Stewart, S. H. (2019). Posttraumatic Stress Symptoms and Coping Motives Mediate the Association Between Childhood Maltreatment and Alcohol Problems. Journal of traumatic stress, 32(6), 918–926. https://doi.org/10.1002/jts.22467
Rodriguez, L., & Read, J. P. (2020). Momentary emotional responding and emotion regulation in PTSD-related drinking urge. Experimental and clinical psychopharmacology, 28(1), 99–111. https://doi.org/10.1037/pha0000292
Sonnier, H., Alex Brake, C., Flores, J., & Badour, C. L. (2019). Posttraumatic stress and hazardous alcohol use in trauma-exposed young adults: indirect effects of self-disgust. Substance use & misuse, 54(7), 1051–1059. https://doi.org/10.1080/10826084.2018.1517173
Subbie-Saenz de Viteri, S., Pandey, A., Pandey, G., Kamarajan, C., Smith, R., Anokhin, A., Bauer, L., Bender, A., Chan, G., Dick, D., Edenberg, H., Kinreich, S., Kramer, J., Schuckit, M., Zang, Y., McCutcheon, V., Bucholz, K., Porjesz, B., & Meyers, J. L. (2020). Pathways to post-traumatic stress disorder and alcohol dependence: Trauma, executive functioning, and family history of alcoholism in adolescents and young adults. Brain and behavior, 10(11), e01789. https://doi.org/10.1002/brb3.1789
Witte, T. H., Weymouth, B. B., Gajos, J. M., Penunuri, A., & Levy, S. (2020). Trauma Exposure and Problem Drinking in Late Adolescence: A Latent Profile Analysis. Journal of traumatic stress, 33(6), 1048–1059. https:// doi.org/10.1002/jts.22599
Yeo, E. J., Hlongwane, K., Otwombe, K., Hopkins, K. L., Variava, E., Martinson, N., Strathdee, S. A., Coetzee, J., & Milovanovic, M. (2022). Key risk factors for substance use among female sex workers in Soweto and Klerksdorp, South Africa: A cross-sectional study. PloS one, 17(1), e0261855. https://doi.org/10.1371/journal.pone.0261855
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