Best Practices for Counselors Who Treat Posttraumatic Stress Disorder

Survival analyses of social support and trauma among homeless male and female veterans who abuse substances

This appears to be the 1st study of gender differences in how well various forms of trauma and social support predict homeless substance abusers' tenure in the community without rehospitalization. Sexual and physical abuses at different stages of the life span, combat exposure, and recent traumatic events were analyzed with social support factors via Cox's proportional hazard model of survival in a 2-year follow-up. The survival models showed similarities and dissimilarities in predictors of tenure in the community for women compared to men among homeless veterans. Traumata and related factors (e.g., depression and suicidal thoughts) were more potent (negative) predictors of tenure, and family and friends were more important social supports, for women than for men. Men's tenure was more positively associated with job satisfaction and more negatively related to substance abuse, combat exposure, cognitive impairments, aggression, and physical health problems. The intervention implications of these findings are discussed.