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Leri J, Cisler JM, Dodd CG, Clark SL, Taylor L, Theodorou A, Belford A, Liberzon I, Rathouz PJ, Newport DJ, Devargas C, Wagner K, Nemeroff CB. The role of recurrent trauma on post-traumatic stress disorder symptoms and substance use among trauma exposed youth. Psychiatry Res 2024; 338:115980. [PMID: 38833935 DOI: 10.1016/j.psychres.2024.115980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 05/17/2024] [Accepted: 05/25/2024] [Indexed: 06/06/2024]
Abstract
Comorbidity between post-traumatic stress disorder (PTSD) and substance use disorder may be explained by a prospective trauma risk conferred by both conditions. The current study modeled concurrent and prospective associations of trauma, PTSD symptoms, and substance use (SU) behavior among trauma exposed youth (ages 8-20). Clinical interviews assessed trauma exposure, PTSD symptom severity, and SU behavior at baseline and at six- and 12-month follow up study visits (N = 2,069). Structural equation models assessed the associations of trauma, PTSD symptoms, and SU behavior. Lifetime trauma was associated with more severe PTSD symptoms and SU behaviors, whereas trauma exposure during the study was only associated with PTSD symptoms. PTSD symptom severity was prospectively associated with trauma exposure. PTSD symptom severity and SU behavior at follow-up study visits were prospectively associated. These results highlight the dynamic interplay between trauma, PTSD symptoms, and SU behavior during youth, a developmental period during which complex psychiatric presentations can have longstanding consequences for health.
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Affiliation(s)
- John Leri
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, 1601 Trinity Street, Austin, TX 78712, United States.
| | - Josh M Cisler
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, 1601 Trinity Street, Austin, TX 78712, United States
| | - Cody G Dodd
- Department of Psychiatry and Behavioral Sciences, The University of Texas Medical Branch, United States
| | - Shaunna L Clark
- Department of Psychiatry & Behavioral Sciences, Texas A&M University, United States
| | - Leslie Taylor
- Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, United States
| | - Arrian Theodorou
- The University of North Texas Health Science Center, United States
| | - Anissa Belford
- Department of Psychiatry and Behavioral Sciences, The University of Texas at San Antonio, United States
| | - Israel Liberzon
- Department of Psychiatry & Behavioral Sciences, Texas A&M University, United States
| | - Paul J Rathouz
- Department of Population Health, The University of Texas at Austin Dell Medical School, United States
| | - D Jeffrey Newport
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, 1601 Trinity Street, Austin, TX 78712, United States; Department of Women's Health, The University of Texas at Austin Dell Medical School, United States
| | - Cecilia Devargas
- Department of Psychiatry, Texas Tech University Health Sciences Center El Paso, United States
| | - Karen Wagner
- Department of Psychiatry and Behavioral Sciences, The University of Texas Medical Branch, United States
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, 1601 Trinity Street, Austin, TX 78712, United States
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Balters S, Schlichting M, Walton TO, Kochenderfer MJ, Kaysen D. A month in review: longitudinal dynamics between daily PTSD symptom networks, affect, and drinking behaviors in female college students. Front Psychol 2024; 15:1388539. [PMID: 39139596 PMCID: PMC11319128 DOI: 10.3389/fpsyg.2024.1388539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 07/03/2024] [Indexed: 08/15/2024] Open
Abstract
Introduction Sexual victimization (SV) is common among college women, with approximately half of those who have experienced SV meeting criteria for posttraumatic stress disorder (PTSD) within a year. Both SV and PTSD are associated with alcohol misuse among college women, often explained by the self-medication hypothesis. Existing literature focuses on overall PTSD severity rather than potential day-to-day fluctuations in specific symptoms, which might play a crucial role in understanding alcohol misuse risk. Studies also examine only same-day or next-day associations between PTSD and drinking, neglecting the potential for longer-term changes. Methods This study explores the short-term longitudinal stability and time-lagged predictive dynamics of PTSD symptoms, affect, and drinking behavior among 174 female college heavy episodic drinkers over four weeks. Participants were categorized into three groups: those with a history of SV and PTSD (n = 77), women with SV but without PTSD (n = 59), and women without prior trauma history (n = 38) to be able to examine differences by trauma exposure, and PTSD. We compared the longitudinal stability of PTSD symptom networks, affect (arousal, positive affect, and negative affect), and drinking behavior across groups. Support vector regression determined which PTSD symptom networks and affect best predict drinking behavior at specific time lags within a 0-7 day range. Results The PTSD group showed higher longitudinal stability for PTSD symptom networks (adjusted ps <.049) and arousal (adjusted ps <.048), but lower stability for negative affect (adjusted p =.013) and drinking behavior, including alcohol cravings (adjusted p =.019) and consumption (adjusted ps =.012), compared to the comparison groups. This suggests individuals with PTSD have more stable symptoms and arousal levels but greater fluctuations in negative affect and alcohol-related behaviors. Secondary analysis revealed PTSD symptom networks optimally predicted alcohol cravings with a three-day time lag (r=.88, p <.001) and consumption with a four-day time lag (r=.82, p <.001). Discussion These findings challenge assumptions regarding immediate effects of PTSD and affect on drinking behavior and underscore the need for therapeutic approaches that consider longer-range effects. Future research should expand on these findings by incorporating longer-range assessments and exploring a broader range of symptom interactions.
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Affiliation(s)
- Stephanie Balters
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, United States
| | - Marc Schlichting
- Department of Aeronautics and Astronautics, School of Engineering, Stanford University, Stanford, CA, United States
| | - Thomas O. Walton
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, United States
| | - Mykel J. Kochenderfer
- Department of Aeronautics and Astronautics, School of Engineering, Stanford University, Stanford, CA, United States
| | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, United States
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Hirai M, Vernon LL, Dials AE. A serial Mediation Model of Depression and Drinking Motives Underlying Problem Drinking Among Hispanic College Women Following Rape. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:2997-3015. [PMID: 38279685 DOI: 10.1177/08862605241226636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
Problem drinking and depression are common following sexual assault. The current study applied a coping motives model of drinking and examined the association between rape experiences and problem drinking serially mediated by depression symptoms and coping-depression drinking motives among Hispanic college women. A total of 330 college women were classified into a single rape experience (SGL) group (n = 44), a multiple rape experiences (MLT) group (n = 70), and a no sexual assault experience group (n = 221). Participants completed self-report measures online. Serial mediation analyses with multi-categorical predictors found that significantly increased alcohol consumptions in rape survivors compared to individuals with no sexual assault experience were largely explained by the serially connected underlying mechanisms of depression symptoms and coping-depression drinking motives. The prevalence rates of rape experiences in this Hispanic female sample are alarming, suggesting Hispanic college women as a particularly vulnerable group for rape. The current results contribute to a greater understanding of the effects of rape experiences on behavioral and emotional outcomes among young Hispanic women who have been underrepresented in sexual victimization research. The findings emphasize the importance of assessing depression symptoms and coping-depression drinking motives in Hispanic rape survivors to reduce risks for hazardous drinking behavior.
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Affiliation(s)
- Michiyo Hirai
- University of Texas Rio Grande Valley, Edinburg, TX, USA
| | | | - Andrew E Dials
- University of Texas Rio Grande Valley, Edinburg, TX, USA
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Bonnesen K, Luo R, Rothenberg R, Smith M, Swartout K. Campus climate impacts on sexual violence: a Bayesian comparison of undergraduate and community colleges. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-12. [PMID: 38754092 DOI: 10.1080/07448481.2024.2351412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 04/28/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVE Sexual violence is endemic on college campuses. Four-year campuses present high-risk environments for sexual violence and heavy episodic drinking is a robust risk factor for victimization. However, limited literature exists on sexual violence at two-year institutions, with most research focused on four-year campuses. We examined whether campus climates affect sexual violence prevalence rates. PARTICIPANTS Sexual misconduct campus climate data from two-year and four-year campus students. METHODS We used Bayesian logistic regressions to compare sexual victimization odds between two- and four-year campuses. RESULTS Four-year students were twice as likely to have experienced sexual victimization and 2.5 times more likely to engage in heavy episodic drinking compared to two-year students. The risk of sexual victimization associated with heavy episodic drinking was reliably similar across campus types. CONCLUSIONS Campus climates reliably impact student's risk of sexual victimization. Based on these findings, two- and four-year campuses may need to implement distinct prevention services.
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Affiliation(s)
- Kamilla Bonnesen
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Ruiyan Luo
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Richard Rothenberg
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | | | - Kevin Swartout
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
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Pedersen ER, Davis JP, Canning L, Tucker JS, Prindle J, Seelam R, Dunbar MS, Siconolfi D, D'Amico EJ. Longitudinal associations among experiences of sexual assault, posttraumatic stress disorder symptoms, and heavy drinking in young adults. J Trauma Stress 2024; 37:243-256. [PMID: 38109146 PMCID: PMC10984762 DOI: 10.1002/jts.23000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 11/03/2023] [Accepted: 11/04/2023] [Indexed: 12/19/2023]
Abstract
Prior research with young adults has demonstrated clear associations between experiences of sexual assault, symptoms of posttraumatic stress disorder (PTSD), and alcohol use, but most studies have been cross-sectional or have not considered multiple theoretical pathways to understand these associations. Using six waves of data from a longitudinal cohort sample of 1,719 young adults, we examined associations among experiences of past-year sexual assault (i.e., rape, unwanted sexual touching, and physical intimidation in a sexual way), PTSD symptoms, and the frequency of binge drinking over time, allowing for the exploration of symptom-induced, interpersonal risk, and substance-induced pathways for male and female participants. For both male, βs = 2.84 to 6.55, and female participants, βs = 2.96 to 10.1, higher prior levels of PTSD symptoms were associated with larger increases in binge drinking over time. For female participants, higher prior levels of sexual assault were associated with larger increases in PTSD symptoms over time, βs = 3.48 to 4.25, whereas for male participants, higher prior levels of past-year binge drinking were associated with decreases in PTSD symptoms over time, βs = -2.75 to -0.53. Continued efforts are needed to prevent sexual assault among young adults and address PTSD symptoms among those who experience sexual assault. Interventions that target binge drinking are also needed for individuals who experience PTSD symptoms, especially young adults, to address potentially hazardous drinking before problems escalate and become chronic.
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Affiliation(s)
- Eric R Pedersen
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | | | - Liv Canning
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | | | - John Prindle
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
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Torres OV, Estep JC, Gwin M, Aramovich NP, Thomas G, Villalta L. Distress symptoms and alcohol consumption: anxiety differentially mediates drinking across gender. Front Psychol 2023; 14:1191286. [PMID: 37583609 PMCID: PMC10423919 DOI: 10.3389/fpsyg.2023.1191286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/13/2023] [Indexed: 08/17/2023] Open
Abstract
Introduction The consumption of alcohol remains a significant health concern and represents a prevalent form of substance use worldwide. Previous research has identified sex differences in the consumption of alcohol. This study explores the relationship between drinking and the presence of distress symptoms across gender. Based on previous research, it was hypothesized that presence of distress symptoms, defined as increases in anxiety and depression, would be prominent features associated with alcohol consumption among women compared to men. Methods A sample of undergraduate students (N = 448) participated in an online-based questionnaire (71% female; M age = 22.1; 42.9% Hispanic/Latino). The questionnaire contained assessments related to demographic information and alcohol consumption over the past 30 days. Anxiety and depression symptoms were assessed using the Hospital Anxiety and Depression Scale. Results Gender differences were observed with men consuming more alcoholic drinks than women. However, women who consumed alcohol reported having more distress symptoms relative to their male counterparts. A logistic regression revealed that this gender difference was moderated by anxiety, such that greater anxiety scores associates with whether women consumed alcohol. However, an ordinary least squares regression revealed that for men, anxiety scores significantly related to the amount of drinks consumed. Gender differences were not detected in relation to alcohol consumption and depression. Conclusion Our findings contribute to the literature by indicating that the mere presence of distress symptoms reveals distinctive gender-specific differences in relation to alcohol consumption in a non-clinical population. Identifying the distinct associations linked with alcohol use for men and women can aid in reducing drinking disparities among young adults.
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Affiliation(s)
- Oscar V. Torres
- Department of Behavioral Sciences, San Diego Mesa College, San Diego, CA, United States
| | - Justin C. Estep
- Department of Behavioral Sciences, San Diego Mesa College, San Diego, CA, United States
| | - Mary Gwin
- Department of Social Sciences, San Diego Mesa College, San Diego, CA, United States
| | - Nicholas P. Aramovich
- Department of Behavioral Sciences, San Diego Mesa College, San Diego, CA, United States
- Department of Behavioral Sciences, San Diego Miramar College, San Diego, CA, United States
| | - Giovanni Thomas
- Department of Behavioral Sciences, San Diego Mesa College, San Diego, CA, United States
| | - Lan Villalta
- Department of Behavioral Sciences, San Diego Mesa College, San Diego, CA, United States
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Nguyen KA, Myers B, Abrahams N, Jewkes R, Mhlongo S, Seedat S, Lombard C, Garcia-Moreno C, Chirwa E, Kengne AP, Peer N. Symptoms of posttraumatic stress partially mediate the relationship between gender-based violence and alcohol misuse among South African women. Subst Abuse Treat Prev Policy 2023; 18:38. [PMID: 37349847 PMCID: PMC10288665 DOI: 10.1186/s13011-023-00549-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/15/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND The association of traumatic experiences with problematic alcohol use has been described, but data on possible mediation effects of mental distress are sparse. We examined whether mental ill-health mediated the association between trauma exposure across the lifespan and alcohol use. METHOD We analysed cross-sectional data from a sample of rape-exposed and non-rape-exposed women, living in KwaZulu-Natal, with self-reported data on alcohol misuse (AUDIT-C cut-off ≥ 3) and exposure to childhood maltreatment (CM), intimate partner violence (IPV), non-partner sexual violence (NPSV), other traumatic events, and mental ill-health. Logistic regression and multiple mediation models were used to test the mediation effects of symptoms of depression and PTSS on the association between abuse/trauma and alcohol misuse. RESULTS Of 1615 women, 31% (n = 498) reported alcohol misuse. Exposure to any CM (adjusted odds ratio (aOR): 1.59, 95% confidence interval (CI): 1.27-1.99), as well as to sexual, physical and emotional CM, were independently associated with alcohol misuse. Lifetime exposure to any IPV (aOR:2.01, 95%CI:1.59-2.54), as well as to physical, emotional and economic IPV, NPSV (aOR: 1.75, 95%CI: 1.32-2.33), and other trauma (aOR:2.08, 95%CI:1.62-2.66), was associated with alcohol misuse. Exposure to an increasing number of abuse types, and other traumatic events, was independently associated with alcohol misuse. PTSS partially mediated the associations of CM, IPV, NPSV and other trauma exposures with alcohol misuse (ps ≤ 0.04 for indirect effects), but depression symptoms did not. CONCLUSIONS These findings highlight the need for trauma-informed interventions to address alcohol misuse that are tailored to the needs of women who have experienced violence.
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Affiliation(s)
- Kim A. Nguyen
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, 7505 and Durban, P.O. Box 19070, Tygerberg, 4091 South Africa
| | - Bronwyn Myers
- Mental Health, Alcohol, Substances, and Tobacco Research Unit, South African Medical Research Council, Cape Town, 7505 Substances South Africa
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6102 Australia
| | - Naeemah Abrahams
- Gender and Health Research Unit, South African Medical Research Council, Cape Town and Pretoria, 7505, 0001 South Africa
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925 South Africa
| | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Cape Town and Pretoria, 7505, 0001 South Africa
- Office of the Executive Scientist, South African Medical Research Council, Cape Town, 7505 South Africa
| | - Shibe Mhlongo
- Gender and Health Research Unit, South African Medical Research Council, Cape Town and Pretoria, 7505, 0001 South Africa
| | - Soraya Seedat
- SAMRC Unit on the Genomics of Brain Disorders, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Carl Lombard
- Biostatistics Unit, South African Medical Research Council, Cape Town, 7505 South Africa
| | - Claudia Garcia-Moreno
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization (WHO), Geneva, Switzerland
| | - Esnat Chirwa
- Gender and Health Research Unit, South African Medical Research Council, Cape Town and Pretoria, 7505, 0001 South Africa
- School of Public Health, University of Witwatersrand, Johannesburg, 2193 South Africa
| | - Andre P. Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, 7505 and Durban, P.O. Box 19070, Tygerberg, 4091 South Africa
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925 South Africa
| | - Nasheeta Peer
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, 7505 and Durban, P.O. Box 19070, Tygerberg, 4091 South Africa
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925 South Africa
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Salazar LF, Schipani-McLaughlin AM, Sebeh Y, Nizam Z, Hayat M. A Web-Based Sexual Violence, Alcohol Misuse, and Bystander Intervention Program for College Women (RealConsent): Randomized Controlled Trial. J Med Internet Res 2023; 25:e43740. [PMID: 37342080 DOI: 10.2196/43740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 03/11/2023] [Accepted: 04/11/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Sexual violence (SV) incidence among college women has been invariant for the past 20 years. Innovative prevention strategies that are low resource and technology driven but demonstrate efficacy are greatly needed. OBJECTIVE The aim of this study was to determine the efficacy of a novel theoretically driven internet-based intervention for first-year college students who identify as women (RealConsent) in reducing their risk of exposure to SV and alcohol misuse as well as increasing alcohol protective and bystander behaviors. METHODS This randomized controlled trial involved first-year college students who identified as women (n=881) attending 1 of 3 universities in the southeastern United States. Participants aged 18 to 20 years were randomized to RealConsent (444/881, 50.4%) or to an attention-matched placebo control (437/881, 49.6%). RealConsent is fully automated and consists of four 45-minute modules that incorporate entertainment-education media and proven behavior change techniques. The primary outcome was exposure to SV; the secondary outcomes were alcohol protective behaviors, dating risk behaviors, alcohol misuse, and bystander behavior. Study outcomes were assessed at baseline and 6-month follow-up. RESULTS Among participants with some exposure to SV, those in the RealConsent group experienced less exposure to SV than the placebo group (adjusted incidence rate ratio 0.48, 95% CI 0.33-0.69; P=.002). Furthermore, participants in the RealConsent group engaged in more alcohol protective behaviors (adjusted odds ratio 1.17, 95% CI 0.12-2.22; P=.03) and were less likely to binge drink (adjusted incidence rate ratio 0.81, 95% CI 0.67-0.97; P=.003). Finally, participants in the RealConsent group who had 100% dosage were more likely to engage in bystander behavior than those with <100% dosage plus placebo group (adjusted odds ratio 1.72, 95% CI 1.17-2.55; P=.006). CONCLUSIONS A comprehensive exposure to SV, alcohol use, and bystander educational program was successful in decreasing the occurrence of exposure to SV among those most at risk and in increasing alcohol protective behaviors. Because of its web-based and mobile technologies, RealConsent can be easily disseminated and holds potential for reducing campus SV. TRIAL REGISTRATION ClinicalTrials.gov NCT03726437; https://clinicaltrials.gov/ct2/show/NCT03726437.
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Affiliation(s)
- Laura Francisca Salazar
- Department of Health Policy and Behavioral Science, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Anne Marie Schipani-McLaughlin
- Department of Health Policy and Behavioral Science, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Yesser Sebeh
- Department Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Zainab Nizam
- Department of Health Policy and Behavioral Science, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Matt Hayat
- Department Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
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Mehr JB, Bennett ER, Price JL, de Souza NL, Buckman JF, Wilde EA, Tate DF, Marshall AD, Dams-O'Connor K, Esopenko C. Intimate partner violence, substance use, and health comorbidities among women: A narrative review. Front Psychol 2023; 13:1028375. [PMID: 36778165 PMCID: PMC9912846 DOI: 10.3389/fpsyg.2022.1028375] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/14/2022] [Indexed: 01/28/2023] Open
Abstract
Exposure to intimate partner violence (IPV), including physical, sexual, and psychological violence, aggression, and/or stalking, impacts overall health and can have lasting mental and physical health consequences. Substance misuse is common among individuals exposed to IPV, and IPV-exposed women (IPV-EW) are at-risk for transitioning from substance misuse to substance use disorder (SUD) and demonstrate greater SUD symptom severity; this too can have lasting mental and physical health consequences. Moreover, brain injury is highly prevalent in IPV-EW and is also associated with risk of substance misuse and SUD. Substance misuse, mental health diagnoses, and brain injury, which are highly comorbid, can increase risk of revictimization. Determining the interaction between these factors on the health outcomes and quality of life of IPV-EW remains a critical need. This narrative review uses a multidisciplinary perspective to foster further discussion and research in this area by examining how substance use patterns can cloud identification of and treatment for brain injury and IPV. We draw on past research and the knowledge of our multidisciplinary team of researchers to provide recommendations to facilitate access to resources and treatment strategies and highlight intervention strategies capable of addressing the varied and complex needs of IPV-EW.
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Affiliation(s)
- Jacqueline B. Mehr
- School of Environmental and Biological Sciences, Rutgers University – New Brunswick, New Brunswick, NJ, United States
| | - Esther R. Bennett
- School of Social Work, Rutgers University - New Brunswick, New Brunswick, NJ, United States
| | - Julianne L. Price
- Department of Kinesiology and Health, Rutgers University - New Brunswick, New Brunswick, NJ, United States,Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers University - New Brunswick, New Brunswick, NJ, United States
| | - Nicola L. de Souza
- School of Graduate Studies, Biomedical Sciences, Rutgers Biomedical and Health Sciences, Newark, NJ, United States,Department of Rehabilitation and Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, United States,Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Jennifer F. Buckman
- Department of Kinesiology and Health, Rutgers University - New Brunswick, New Brunswick, NJ, United States,Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers University - New Brunswick, New Brunswick, NJ, United States
| | - Elisabeth A. Wilde
- Department of Neurology, School of Medicine, The University of Utah, Salt Lake City, UT, United States,George E. Wahlen, VA Salt Lake City Healthcare System, Research Care Line, Salt Lake City, UT, United States
| | - David F. Tate
- Department of Neurology, School of Medicine, The University of Utah, Salt Lake City, UT, United States,George E. Wahlen, VA Salt Lake City Healthcare System, Research Care Line, Salt Lake City, UT, United States
| | - Amy D. Marshall
- Department of Psychology, College of the Liberal Arts, The Pennsylvania State University, State College, PA, United States
| | - Kristen Dams-O'Connor
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States,Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Carrie Esopenko
- Department of Rehabilitation and Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, United States,Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States,*Correspondence: Carrie Esopenko,
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Campoverde F, de las Casas M, Blitchtein-Winicki D. Is There an Association between Being a Victim of Physical Violence by Intimate Partner and Binge Drinking in Men and Women? Secondary Analysis of a National Study, Peru 2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14403. [PMID: 36361292 PMCID: PMC9658480 DOI: 10.3390/ijerph192114403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/30/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
The relationship between being a victim of physical violence by an intimate partner and binge drinking (BD) is a poorly explored line of research, especially in men. To determine the association between being a victim of physical violence by an intimate partner and BD in men and women in Peru in 2020, a secondary analytical cross-sectional study was conducted using the Demographic Health Survey. BD was categorized according to the Center of Disease Control definition for men and women, based on the type and amount of alcoholic beverage ingested. Physical violence was based the report of being hit with any part of the body or an object, by their intimate partner. To identify the association, a multivariable general linear model of the family and link log Poisson was used. The results were presented as prevalence ratios (PRs). In the adjusted models stratified by sex, a 90% greater likelihood of BD was found in male victims and an 80% higher probability among female victims (PRa 1.9, 95%CI 1.3;2.7, p < 0.001 vs. PRa 1.8, CI95% 1.1; 2.8, p = 0.013, respectively). An association was found between physical violence by an intimate partner and BD in the Peruvian population older than 15 years, in both men and women.
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11
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Sutton TE, Edwards KM, Siller L, Shorey RC. An Exploration of Factors that Mediate the Relationship Between Adverse Childhood Experiences and Sexual Assault Victimization Among LGBTQ+ College Students. CHILD MALTREATMENT 2022; 27:539-549. [PMID: 34569316 DOI: 10.1177/10775595211041970] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Despite alarming rates of sexual assault on college campuses, little research has examined risk factors for sexual victimization among LGBTQ+ college students. This exploratory study aims to examine adolescent sexual assault, internalized homonegativity, and problematic alcohol use as mediators linking several types of adverse childhood experiences (ACEs; i.e., childhood sexual abuse, parental abuse, and household disorder) to collegiate sexual assault. Utilizing data from 241 LGBTQ+ college students, path analysis findings demonstrated that these proposed mediators increased risk for sexual assault and that various types of ACEs exerted differential impacts on sexual re-victimization, internalized homonegativity, and problematic alcohol use. Practice-based implications are offered, including the need for affirming programming that includes problem drinking prevention components and considers the role of ACEs and internalized homonegativity in increasing risk for sexual assault during college as well as the need for LGBTQ+ resource centers on campus.
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Affiliation(s)
- Tara E Sutton
- 5547Department of Sociology, Mississippi State University, Starkville, MS, USA
| | - Katie M Edwards
- 14719Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Laura Siller
- 14719Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Ryan C Shorey
- 14751Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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12
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Iverson KM, Rossi FS, Nillni YI, Fox AB, Galovski TE. PTSD and Depression Symptoms Increase Women's Risk for Experiencing Future Intimate Partner Violence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12217. [PMID: 36231518 PMCID: PMC9566456 DOI: 10.3390/ijerph191912217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/08/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
Psychological distress may impact women's risk for future intimate partner violence (IPV). Yet, limited research has utilized longitudinal research designs and there is a scarcity of research looking at the three most commonly implicated mental health factors-posttraumatic stress disorder (PTSD), depression, and alcohol use-within the same study. Research is especially scarce for women veterans, who experience substantial risk for these mental health concerns and experiencing IPV. This study examined the role of PTSD symptoms, depression symptoms, and alcohol use in increasing risk for experiencing future IPV while simultaneously accounting for the impact of recent IPV experience on subsequent mental health. This study included a sample of 1921 women veterans (Mage = 36.5), who were asked to complete three mail surveys over the course of 8 months as part of a larger longitudinal survey study of US veterans' health and well-being. The survey assessed experiences of IPV, PTSD symptoms (PCL-5), depression symptoms (PHQ-9), and alcohol use (AUDIT-C) at each of the three time points. Results from separate path analysis models provided support for the role of PTSD symptoms and depression symptoms (but not alcohol use) in increasing risk for IPV experience over time. However, the path analysis models provided little support, with the exception of PTSD, for the impact of IPV experience on subsequent mental health symptoms. Findings point to the importance of better understanding the mechanisms by which PTSD and depression symptoms can increase risk for IPV to inform theory and prevention and treatment efforts. Detection and treatment of PTSD and depression symptoms among women may help reduce risk for future violence in intimate relationships.
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Affiliation(s)
- Katherine M. Iverson
- Women’s Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, Boston, MA 02130, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA 02118, USA
| | - Fernanda S. Rossi
- Women’s Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, Boston, MA 02130, USA
- Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Menlo Park, CA 94025, USA
- Center for Primary Care and Outcomes Research (PCOR), Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Yael I. Nillni
- Women’s Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, Boston, MA 02130, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA 02118, USA
| | - Annie B. Fox
- Women’s Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, Boston, MA 02130, USA
- School of Healthcare Leadership, Massachusetts General Hospital Institute of Health Professions, Boston, MA 02129, USA
| | - Tara E. Galovski
- Women’s Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, Boston, MA 02130, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA 02118, USA
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13
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Goodrum NM, Bernard DL, Moreland AD. Interpersonal Violence, PTSD, and Substance Use Types among Women Receiving Substance Use Treatment. J Dual Diagn 2022; 18:123-134. [PMID: 35802744 PMCID: PMC9721397 DOI: 10.1080/15504263.2022.2090649] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Objective: Many women receiving substance use treatment report histories of interpersonal violence (IV) victimization, including physical and sexual assault. IV is a risk factor for mental and behavioral health difficulties such as posttraumatic stress disorder (PTSD) and substance use disorder (SUD). Consistent with the self-medication hypothesis, PTSD may explain elevated SUD among IV survivors. Yet, few studies have investigated whether PTSD may have differential mediating effects for different substances, which has significant treatment implications. Methods: In 124 women (M age = 35.37, SD = 11.90) in substance use treatment, we examined PTSD symptoms as a mediator between IV and severity of different types of substance use, including alcohol, cannabis, cocaine, and opioid use. Participants completed self-report measures including the ASSIST, PCL-5, and LEC-5. Data were analyzed using path analysis in Mplus 8.3. Both dichotomous and continuous outcomes of problematic substance use outcomes were examined. Results: Most women (53.3%) reported problematic substance use with at least one substance, including opioids (39.7%), cocaine (13.0%), alcohol (9.6%), and cannabis (5.6%). Most (83.2%) of the sample reported at least one IV incident. On average, women reported clinically significant PTSD symptom severity. When problematic substance use was examined dichotomously, findings revealed significant indirect effects from IV exposure to opioid (β = 0.10, p = .010) and cocaine use (β = 0.07, p = .039) via elevated PTSD symptoms. There were no significant indirect effects for problematic alcohol (β = 0.03, p = .260) or cannabis use (β = 0.02, p = .562). When substance use was examined continuously, results revealed significant indirect effects from IV exposure to opioid (β = 0.09, p = .017), cocaine use (β = 0.09, p = .015), and alcohol use (β = 0.08, p = .020) via elevated PTSD symptoms. Indirect effects for cannabis use remained nonsignificant (β = 0.05, p = .100). Conclusions: IV survivors may be particularly at risk for opioid and cocaine misuse because of elevated PTSD symptoms. Treatments that integrate PTSD and SUD are needed to simultaneously target traumatic stress and substance use. Women with opioid and cocaine misuse may particularly benefit from trauma-focused exposure-based psychotherapy to reduce symptoms of PTSD, and thus, decrease opioid and cocaine misuse.
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Affiliation(s)
- Nada M Goodrum
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Donte L Bernard
- Department of Psychological Sciences, University of Missouri, Missouri, USA.,National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Angela D Moreland
- National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston, South Carolina, USA
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14
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Jaffe AE, Blayney JA, Graupensperger S, Cooper R, Larimer ME. Prepartying and incapacitated rape: Is drinking a risk factor or an outcome? Alcohol Clin Exp Res 2022; 46:447-457. [PMID: 35076100 PMCID: PMC8966982 DOI: 10.1111/acer.14779] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/30/2021] [Accepted: 01/09/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Incapacitated rape (IR) is common in college and has been linked to heavier post-assault drinking and consequences, including blackouts. Following IR, college students may adjust their drinking in ways meant to increase perceived safety, such as enhancing situational control over one's drinks through prepartying, which is drinking before going out to a main social event. Although it is possible that prepartying could influence risk related to IR, it is unclear whether or how prepartying and IR are associated. METHODS To address these gaps, we examined prepartying as both a risk factor and a consequence of IR, including the reasons for prepartying. Across two studies (Study 1 N = 1074; Study 2 N = 1753) of college women and men, we examined associations between IR and prepartying motives, alcohol consumption, and alcohol-related blackouts. RESULTS Within the cross-sectional Study 1, negative binomial regressions revealed that having a history of IR was associated with more alcohol consumption and blackouts when prepartying. In a multivariate model, past-year IR was associated with preparty motives related to interpersonal enhancement, intimate pursuit, and barriers to consumption, but not situational control. Within the prospective Study 2, a path model revealed that preparty drinking was a prospective predictor of IR in the following year, but past-year IR did not predict subsequent prepartying. CONCLUSIONS Findings revealed a robust link between recent history of IR and prepartying regardless of gender. Prepartying was a prospective risk factor for subsequent IR. Although more research in this area is needed, addressing prepartying in alcohol interventions may contribute to the prevention of negative outcomes, including sexual assault.
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Affiliation(s)
- Anna E Jaffe
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Jessica A Blayney
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Scott Graupensperger
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Rachel Cooper
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Mary E Larimer
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
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15
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Kirson D, Steinman MQ, Wolfe SA, Bagsic SRS, Bajo M, Sureshchandra S, Oleata CS, Messaoudi I, Zorrilla EP, Roberto M. Sex and context differences in the effects of trauma on comorbid alcohol use and post-traumatic stress phenotypes in actively drinking rats. J Neurosci Res 2021; 99:3354-3372. [PMID: 34687080 PMCID: PMC8712392 DOI: 10.1002/jnr.24972] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/02/2021] [Accepted: 09/18/2021] [Indexed: 02/06/2023]
Abstract
Alcohol use disorder (AUD) and affective disorders are frequently comorbid and share underlying mechanisms that could be targets for comprehensive treatment. Post-traumatic stress disorder (PTSD) has high comorbidity with AUD, but comprehensive models of this overlap are nascent. We recently characterized a model of comorbid AUD and PTSD-like symptoms, wherein stressed rats receive an inhibitory avoidance (IA)-related footshock on two occasions followed by two-bottle choice (2BC) voluntary alcohol drinking. Stressed rats received the second footshock in a familiar (FAM, same IA box as the first footshock) or novel context (NOV, single-chambered apparatus); the FAM paradigm more effectively increased alcohol drinking in males and the NOV paradigm in females. During abstinence, stressed males displayed avoidance-like PTSD symptoms, and females showed hyperarousal-like PTSD symptoms. Rats in the model had altered spontaneous action potential-independent GABAergic transmission in the central amygdala (CeA), a brain region key in alcohol dependence and stress-related signaling. However, PTSD sufferers may have alcohol experience prior to their trauma. Here, we therefore modified our AUD/PTSD comorbidity model to provide 3 weeks of intermittent extended alcohol access before footshock and then studied the effects of NOV and FAM stress on drinking and PTSD phenotypes. NOV stress suppressed the escalation of alcohol intake and preference seen in male controls, but no stress effects were seen on drinking in females. Additionally, NOV males had decreased action potential-independent presynaptic GABA release and delayed postsynaptic GABAA receptor kinetics in the CeA compared to control and FAM males. Despite these changes to alcohol intake and CeA GABA signaling, stressed rats showed broadly similar anxiogenic-like behaviors to our previous comorbid model, suggesting decoupling of the PTSD symptoms from the AUD vulnerability for some of these animals. The collective results show the importance of alcohol history and trauma context in vulnerability to comorbid AUD/PTSD-like symptoms.
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Affiliation(s)
- Dean Kirson
- The Scripps Research Institute, Department of Molecular Medicine, La Jolla, CA 92037, USA
| | - Michael Q. Steinman
- The Scripps Research Institute, Department of Molecular Medicine, La Jolla, CA 92037, USA
| | - Sarah A. Wolfe
- The Scripps Research Institute, Department of Molecular Medicine, La Jolla, CA 92037, USA
| | | | - Michal Bajo
- The Scripps Research Institute, Department of Molecular Medicine, La Jolla, CA 92037, USA
| | - Suhas Sureshchandra
- University of California Irvine, Department of Molecular Biology and Biochemistry, Irvine, CA 92697, USA
| | - Christopher S. Oleata
- The Scripps Research Institute, Department of Molecular Medicine, La Jolla, CA 92037, USA
| | - Ilhem Messaoudi
- University of California Irvine, Department of Molecular Biology and Biochemistry, Irvine, CA 92697, USA
| | - Eric P. Zorrilla
- The Scripps Research Institute, Department of Molecular Medicine, La Jolla, CA 92037, USA
| | - Marisa Roberto
- The Scripps Research Institute, Department of Molecular Medicine, La Jolla, CA 92037, USA
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