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Childhood Trauma and Dissociation Correlates in Alcohol Use Disorder: A Cross-Sectional Study in a Sample of 587 French Subjects Hospitalized in a Rehabilitation Center. Brain Sci 2022; 12:brainsci12111483. [DOI: 10.3390/brainsci12111483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022] Open
Abstract
This study aimed to determine whether dissociative symptoms and childhood trauma (CT) may help identify a specific subgroup of patients among those hospitalized for alcohol use disorder (AUD). We assessed 587 patients hospitalized for an AUD in a French addiction rehabilitation center (cross-sectional study) regarding dissociative symptoms (DES-taxon), childhood trauma (CTQ), depression (BDI), anxiety (STAI-state and STAI-trait), posttraumatic stress disorder (PTSD; PCL-5), and AUD symptoms (AUDIT). We ran a hierarchical cluster analysis and compared the clusters in terms of dissociation and CT, as well as AUD, depressive, anxiety, and PTSD symptoms. We identified three clusters of patients: (1) patients with low AUD severity and low dissociation (LALD); (2) patients with high AUD severity and low dissociation (HALD); (3) patients with high AUD severity and high dissociation (HAHD). Patients from the HAHD group had significantly higher dissociation and more severe depression, anxiety, and PTSD symptoms than those with LALD and HALD. They also reported more emotional and sexual abuse than those with LALD. Among patients with an AUD, those with high dissociation may constitute an independent subgroup that exhibits a higher prevalence for CT and higher AUD severity, as well as higher depression, anxiety, and PTSD symptoms. Patients with more severe AUD and associated psychiatric symptoms should be systematically screened for dissociation and provided with tailor-based treatments.
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Brunault P, Lebigre K, Idbrik F, Maugé D, Adam P, Barrault S, Baudin G, Courtois R, El Ayoubi H, Grall-Bronnec M, Hingray C, Ballon N, El-Hage W. Childhood Trauma Predicts Less Remission from PTSD among Patients with Co-Occurring Alcohol Use Disorder and PTSD. J Clin Med 2020; 9:jcm9072054. [PMID: 32629872 PMCID: PMC7408730 DOI: 10.3390/jcm9072054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/16/2020] [Accepted: 06/27/2020] [Indexed: 01/17/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) is highly prevalent among patients hospitalized for an alcohol use disorder (AUD). Hospitalization can improve PTSD and AUD outcomes in some but not all patients, but we lack data on the baseline predictors of PTSD non-remission. This study aimed to determine the baseline risk factors for non-remitted PTSD in patients hospitalized for an AUD. Of 298 AUD inpatients recruited in a rehabilitation center (Le Courbat, France), we included 91 AUD inpatients with a co-occurring PTSD and a longitudinal assessment at baseline (T1) and before discharge (T2: 8 weeks later). Patients were assessed for PTSD diagnosis/severity (PCL-5=PTSD Checklist for DSM-5), different types of trauma including childhood trauma (LEC-5=Life Events Checklist for DSM-5/CTQ-SF=Childhood Trauma Questionnaire, Short-Form), and AUD diagnosis/severity (clinical interview/AUDIT=Alcohol Use Disorders Identification Test). Rate of PTSD remission between T1 and T2 was 74.1%. Non-remitted PTSD at T2 was associated with a history of childhood trauma (physical, emotional or sexual abuse, physical negligence), but not with other types of trauma experienced, nor baseline PTSD or AUD severity. Among patients hospitalized for an AUD with co-occurring PTSD, PTSD remission was more strongly related to the existence of childhood trauma than to AUD or PTSD severity at admission. These patients should be systematically screened for childhood trauma in order to tailor evidence-based interventions.
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Affiliation(s)
- Paul Brunault
- CHRU de Tours, Service d’Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, 37044 Tours, France; (K.L.); (D.M.); (H.E.A.); (N.B.)
- CHRU de Tours, Clinique Psychiatrique Universitaire, 37044 Tours, France; (R.C.); (W.E.-H.)
- UMR 1253, iBrain, Université de Tours, Inserm, 37020 Tours, France
- Qualipsy EE 1901, Université de Tours, 37020 Tours, France; (S.B.); (G.B.)
- Correspondence: ; Tel.: +33-218-370-581
| | - Kevin Lebigre
- CHRU de Tours, Service d’Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, 37044 Tours, France; (K.L.); (D.M.); (H.E.A.); (N.B.)
- CHRU de Tours, Clinique Psychiatrique Universitaire, 37044 Tours, France; (R.C.); (W.E.-H.)
| | - Fatima Idbrik
- Soins de Suite et de Réadaptation en Addictologie “Le Courbat”, 37460 Le Liège, France; (F.I.); (P.A.)
| | - Damien Maugé
- CHRU de Tours, Service d’Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, 37044 Tours, France; (K.L.); (D.M.); (H.E.A.); (N.B.)
- CHRU de Tours, Centre de Soins d’Accompagnement et de Prévention en Addictologie CSAPA-37, 37044 Tours, France
| | - Philippe Adam
- Soins de Suite et de Réadaptation en Addictologie “Le Courbat”, 37460 Le Liège, France; (F.I.); (P.A.)
| | - Servane Barrault
- Qualipsy EE 1901, Université de Tours, 37020 Tours, France; (S.B.); (G.B.)
- CHRU de Tours, Centre de Soins d’Accompagnement et de Prévention en Addictologie CSAPA-37, 37044 Tours, France
| | - Grégoire Baudin
- Qualipsy EE 1901, Université de Tours, 37020 Tours, France; (S.B.); (G.B.)
- Laboratory of Psychopathology and Health Processes EA 4057, University Paris Descartes, Sorbonne Paris Cité, 92100 Boulogne-Billancourt, France
| | - Robert Courtois
- CHRU de Tours, Clinique Psychiatrique Universitaire, 37044 Tours, France; (R.C.); (W.E.-H.)
- Qualipsy EE 1901, Université de Tours, 37020 Tours, France; (S.B.); (G.B.)
| | - Hussein El Ayoubi
- CHRU de Tours, Service d’Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, 37044 Tours, France; (K.L.); (D.M.); (H.E.A.); (N.B.)
- CHRU de Tours, Centre de Soins d’Accompagnement et de Prévention en Addictologie CSAPA-37, 37044 Tours, France
| | - Marie Grall-Bronnec
- Addictology and Psychiatry Department, Hôpital Saint Jacques, University Hospital of Nantes, 85 rue Saint Jacques, Cedex 1, 44093 Nantes, France;
- Inserm, SPHERE U1246 methodS in Patients-Centered Outcomes and HEalth ResEarch, Université de Nantes, Université de Tours, 22 boulevard Benoni Goullin, 44200 Nantes, France
| | - Coraline Hingray
- Pôle Universitaire du Grand Nancy, Centre Psychothérapique de Nancy, 54520 Laxou, France;
| | - Nicolas Ballon
- CHRU de Tours, Service d’Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, 37044 Tours, France; (K.L.); (D.M.); (H.E.A.); (N.B.)
- CHRU de Tours, Clinique Psychiatrique Universitaire, 37044 Tours, France; (R.C.); (W.E.-H.)
- UMR 1253, iBrain, Université de Tours, Inserm, 37020 Tours, France
| | - Wissam El-Hage
- CHRU de Tours, Clinique Psychiatrique Universitaire, 37044 Tours, France; (R.C.); (W.E.-H.)
- UMR 1253, iBrain, Université de Tours, Inserm, 37020 Tours, France
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Lotzin A, Grundmann J, Hiller P, Pawils S, Schäfer I. Profiles of Childhood Trauma in Women With Substance Use Disorders and Comorbid Posttraumatic Stress Disorders. Front Psychiatry 2019; 10:674. [PMID: 31681026 PMCID: PMC6813657 DOI: 10.3389/fpsyt.2019.00674] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 08/20/2019] [Indexed: 12/25/2022] Open
Abstract
Background: It is increasingly becoming accepted that substance use disorders, including substance abuse and substance dependence, are closely related to childhood trauma and posttraumatic stress disorders. Among women with substance use disorders, the majority report sexual, physical or emotional abuse, or neglect. However, it is poorly understood which types of childhood trauma co-occur in women with substance use disorders and how combinations of different types and severities of childhood trauma are related to clinical characteristics. This information is important to inform treatment of substance use disorders. Aim: The first aim of this research was to investigate profiles of childhood trauma in female patients with substance use disorders and posttraumatic stress disorders. The second aim was to examine relationships between these childhood trauma profiles and addiction characteristics or current clinical symptoms. Methods: We includeda 343 treatment-seeking women with substance use disorders and comorbid posttraumatic stress disorders according to DSM-IV. Five types of childhood trauma (sexual abuse, physical abuse, emotional abuse) were measured using the Childhood Trauma Questionnaire. Addiction characteristics were assessed by using the Addiction Severity Index-lite. Current severity of clinical symptoms was determined by the Symptom-Checklist-27. Latent profile analysis was conducted to distinguish profiles of childhood trauma. Analysis of variance was applied to examine the relationship between childhood trauma profiles and addiction characteristics or severity of clinical symptoms. Results: Nine out of ten women reported at least one type of childhood abuse or neglect. Four different childhood trauma profiles could be distinguished that characterized different types and severities of childhood trauma: 'Low trauma'; 'Moderate sexual abuse and emotional abuse'; 'Severe sexual abuse and emotional abuse'; and 'Severe levels of all types of trauma'. Profiles with more severe levels of childhood trauma showed an earlier age at initiation and escalation of substance use. Furthermore, childhood trauma profiles were related to current severity of depressive symptoms, dysthymic symptoms, sociophobic symptoms, and distrust. Conclusion: In women with substance use disorders and posttraumatic stress disorders, childhood trauma profiles can inform about addiction characteristics and severity of a wide range of clinical symptoms. This information is essential to understand current treatment needs and should be systematically assessed in women with substance use disorders and trauma exposure.
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Affiliation(s)
- Annett Lotzin
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
| | - Johanna Grundmann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
| | - Philipp Hiller
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
| | - Silke Pawils
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
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