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Stevens L, Bregulla M, Scheele D. Out of touch? How trauma shapes the experience of social touch - Neural and endocrine pathways. Neurosci Biobehav Rev 2024; 159:105595. [PMID: 38373642 DOI: 10.1016/j.neubiorev.2024.105595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/20/2024] [Accepted: 02/15/2024] [Indexed: 02/21/2024]
Abstract
Trauma can shape the way an individual experiences the world and interacts with other people. Touch is a key component of social interactions, but surprisingly little is known about how trauma exposure influences the processing of social touch. In this review, we examine possible neurobiological pathways through which trauma can influence touch processing and lead to touch aversion and avoidance in trauma-exposed individuals. Emerging evidence indicates that trauma may affect sensory touch thresholds by modulating activity in the primary sensory cortex and posterior insula. Disturbances in multisensory integration and oxytocin reactivity combined with diminished reward-related and anxiolytic responses may induce a bias towards negative appraisal of touch contexts. Furthermore, hippocampus deactivation during social touch may reflect a dissociative state. These changes depend not only on the type and severity of the trauma but also on the features of the touch. We hypothesise that disrupted touch processing may impair social interactions and confer elevated risk for future stress-related disorders.
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Affiliation(s)
- Laura Stevens
- Social Neuroscience, Research Center One Health Ruhr of the University Alliance Ruhr, Faculty of Medicine, Ruhr University Bochum, Germany; Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University Bochum, Germany
| | - Madeleine Bregulla
- Social Neuroscience, Research Center One Health Ruhr of the University Alliance Ruhr, Faculty of Medicine, Ruhr University Bochum, Germany; Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University Bochum, Germany
| | - Dirk Scheele
- Social Neuroscience, Research Center One Health Ruhr of the University Alliance Ruhr, Faculty of Medicine, Ruhr University Bochum, Germany; Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University Bochum, Germany.
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2
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Ibrahim M. Dhagan Celis (Cultural Rehabilitation): Somali Canadians Transnational Approach to Youth Substance Use. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01843-8. [PMID: 37935946 DOI: 10.1007/s40615-023-01843-8] [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: 06/13/2023] [Revised: 10/01/2023] [Accepted: 10/13/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Evidence suggests that some Somali youth who settled in Canada struggle with substance use problems, yet research remains limited in understanding the Somali community's experiences and struggles in supporting their youth affected by substance use. OBJECTIVE This study aims to contribute important knowledge in understanding substance use among Somali Canadian youth and access to treatments in Canada and the transnational cultural healing services available in East Africa. METHODS Qualitative interviews (n = 37) were conducted in a metropolitan Canadian city and Nairobi, Kenya, from May 2016 to May 2017. In addition, a field study (n = 4) of rehabilitation centers in Kenya was carried out. RESULTS Through thematic analysis, five main themes were identified: (i) discrimination and racism in the school environment, (ii) emotional pain and self-medication, (iii) low literacy on substance use and treatment in the Canadian context, (iv) stigma, and (v) dhagan celis (cultural rehabilitation) in transnational setting. CONCLUSIONS The study provides evidence of the need to address substance use and trauma among refugee youth in the post-resettlement context especially as Canada currently deals with a significant public health crisis in the form of opioid overdose and substance use.
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Affiliation(s)
- Mohamed Ibrahim
- School of Social Work, The University of British Columbia, 2080 West Mall, Vancouver, V6T 1Z2, Canada.
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3
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Pham TL, Nguyen TL, Nguyen KA, Ekwaru JP, Phan O, Michel L, Khuat THO. Screening for adverse childhood experiences among young people using drugs in Vietnam: related factors and clinical implications. J Public Health (Oxf) 2023; 45:e400-e408. [PMID: 37169578 DOI: 10.1093/pubmed/fdac163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 10/11/2022] [Accepted: 12/06/2022] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Research evidence shows a strong association between adverse childhood experiences (ACEs) and later-life substance use. But little is known about the prevalence and impact of ACEs among young people using drugs (YPUD) in Vietnam. METHOD A cross-sectional study using respondent-driven sampling and peer recruitment methods was conducted among YPUD aged 16-24 in three cities in Vietnam. Eligible participants were screened for ACEs using the ACE-IQ, tested for HIV and hepatitis C, and assessed for sociodemographic and behavioral characteristics. RESULTS Data were collected on 553 individuals whose median age was 20: 79% were male, 18.3% women and 2.7% transgender. Methamphetamine use was reported by 75.8% of participants. 85.5% reported at least one ACE and 27.5% had four ACEs or more. An ACE score of 4 or higher was associated with female and transgender, lower educational level, methamphetamine use, buying sex, depression, psychotic symptoms and expressed need for mental health support. CONCLUSIONS ACEs were found to be very common among YPUD in Vietnam. It is therefore strongly recommended that these young people should be provided with a comprehensive and secure assessment and care that includes not only essential harm reduction and addiction treatment needs but also addresses their mental health needs.
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Affiliation(s)
- Thanh Luan Pham
- Hanoi Medical University Hospital, Hanoi, Vietnam
- Center for Training and Research on Substance abuse - HIV, Hanoi Medical University, 01 Ton That Tung street, Dong Da District, Hanoi, Vietnam
| | | | - Kieu An Nguyen
- Supporting Community Development Initiative, Hanoi, Vietnam
| | - John Paul Ekwaru
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Olivier Phan
- CESP/Inserm 1018, Centre Pierre Nicole, French Red Cross, Paris, France
| | - Laurent Michel
- CESP/Inserm 1018, Centre Pierre Nicole, French Red Cross, Paris, France
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Im S, Fitzpatrick S, Hien DA, Lopez-Castro T, Pawlak A, Melara RD. Frontal Alpha Asymmetry in Children with Trauma Exposure. Clin EEG Neurosci 2022; 53:418-425. [PMID: 35125036 DOI: 10.1177/15500594221076346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of the current study was to investigate differences in frontal alpha asymmetry (FAA) between children (5-17 years) with or without histories of trauma exposure. EEG data were obtained from 165 children who participated in the Healthy Brain Network Initiative during rest with eyes open and closed. FAA during resting-state electroencephalography was significantly more negative in the trauma-exposed group, suggesting greater left lateralized FAA and avoidance-oriented motivation. Moreover, alpha suppression (difference in alpha amplitude between eyes open and eyes closed conditions) was marginally greater in the trauma-exposed group. The results suggest that early exposure to trauma may be associated with trait-level avoidance of environmental stimuli, which ultimately may be predictive of psychopathology, including posttraumatic stress disorder (PTSD). Study findings thus provide preliminary evidence of brain-based mechanisms that may confer risk for PTSD in the wake of early trauma exposure.
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Affiliation(s)
- Sungjin Im
- 1889Western Kentucky University, Department of Psychology, 1906 College Heights Blvd, Bowling Green, KY 42101, USA.,242612Rutgers University, Center of Alcohol & Substance Use Studies, Rutgers Graduate School of Applied and Professional Psychology, 607 Allison Road, Smithers Hall, 222, Piscataway, NJ 08854, USA
| | - Skye Fitzpatrick
- 7991York University, Department of Psychology, 4700 Keele Street, Toronto, ON, M3J 1P3, USA
| | - Denise A Hien
- 242612Rutgers University, Center of Alcohol & Substance Use Studies, Rutgers Graduate School of Applied and Professional Psychology, 607 Allison Road, Smithers Hall, 222, Piscataway, NJ 08854, USA
| | - Teresa Lopez-Castro
- 14770The City College, 14780City University of New York, Psychology Department, 160 Convent Avenue, NAC 7 to 120, New York, NY 10031, USA
| | - Anthony Pawlak
- 242612Rutgers University, Center of Alcohol & Substance Use Studies, Rutgers Graduate School of Applied and Professional Psychology, 607 Allison Road, Smithers Hall, 222, Piscataway, NJ 08854, USA
| | - Robert D Melara
- 14770The City College, 14780City University of New York, Psychology Department, 160 Convent Avenue, NAC 7 to 120, New York, NY 10031, USA
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5
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Mitra S, Lee W, Hayashi K, Boyd J, Milloy M, Dong H, Wood E, Kerr T. A gender comparative analysis of post-traumatic stress disorder among a community-based cohort of people who use drugs in Vancouver, Canada. Addict Behav 2021; 115:106793. [PMID: 33421746 DOI: 10.1016/j.addbeh.2020.106793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/18/2020] [Accepted: 12/16/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND While exposure to traumatic events and subsequent post-traumatic stress disorder (PTSD) are common among people who use drugs (PWUD), little is known about gender-based differences associated with PTSD in this population. We explore gender-based differences in factors associated with a probable PTSD diagnosis in a cohort of PWUD from Vancouver, Canada. METHODS Data were collected through the Vancouver Injection Drug Users Study (VIDUS) and the AIDS Care Cohort to Evaluate Exposure to Survival Services (ACCESS), two community-recruited cohorts of PWUD. Participants were administered the PTSD Checklist for DSM-5. Multivariable logistic regression was used to investigate social-structural factors and substance use patterns and behaviours associated with a probable PTSD diagnosis, stratified by self-identified gender. PTSD symptom clusters and brief descriptions of the worst traumatic event experienced were also reported. RESULTS Between December 2016 and December 2018, of 797 eligible participants, 295 (37.0%) identified as women. PTSD was more commonly reported in women compared to men (53.2% vs. 31.5%, p < 0.001). In multivariable analysis involving men, no correlates were associated with PTSD. In multivariable analysis involving women, PTSD was positively associated with exposure to violence (AOR: 3.66; 95%CI: 1.14-11.72), daily stimulant use (AOR: 2.32; 95%CI: 1.32-4.08) and heavy alcohol use (AOR: 3.84; 95%CI: 1.84-8.00), and negatively associated with being in a stable relationship (AOR: 0.46; 95%CI: 0.25-0.84). CONCLUSIONS Gender-based differences in PTSD diagnosis among a cohort of PWUD point to the need to develop gender-focused and trauma-informed health and social services to meet the immediate needs of PWUD living with PTSD.
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Park S, Lee M, Park SJ, Lee MG. Health risk behaviors and psychological problems among South Korean, North Korean, and other multicultural family adolescents (2011-2016). Psychiatry Res 2018; 268:373-380. [PMID: 30103182 DOI: 10.1016/j.psychres.2018.07.042] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 05/28/2018] [Accepted: 07/29/2018] [Indexed: 11/26/2022]
Abstract
This study was aimed to investigate the health risk behaviors and psychological problems among North Korean, other multicultural, and South Korean family adolescents. The data were collected from the Korea Youth Risk Behavior web-based survey (2011-2016) data set. A total of 17,195 adolescents (mean age 14.65 ± 0.01 years) were analyzed to compare health risk behaviors and psychological problems among the three groups. Concerning risk behaviors, multicultural family adolescents showed a higher rate of alcohol use, smoking, drug use and sexual relations compared to South Korean family adolescents. Moreover, North Korean family adolescents were more likely to experience those risk behaviors than other multicultural family adolescents. Concerning psychological problems, multicultural family youth displayed more depressed mood, and more suicidal ideation, planning, and attempts when compared with South Korean family youth. Among multicultural families, North Korean family adolescents were more depressed and showed higher suicidality. School-based education and preventive interventions are necessary to manage risk behaviors and psychological difficulties of adolescents in North Korean and other multicultural families.
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Affiliation(s)
- Subin Park
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, 127, Yongmasan-ro, Gwangin-gu, Seoul 04933, South Korea.
| | - Minji Lee
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, 127, Yongmasan-ro, Gwangin-gu, Seoul 04933, South Korea
| | - Se Jin Park
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, 127, Yongmasan-ro, Gwangin-gu, Seoul 04933, South Korea
| | - Min Geu Lee
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, 127, Yongmasan-ro, Gwangin-gu, Seoul 04933, South Korea
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Hoppen TH, Chalder T. Childhood adversity as a transdiagnostic risk factor for affective disorders in adulthood: A systematic review focusing on biopsychosocial moderating and mediating variables. Clin Psychol Rev 2018; 65:81-151. [PMID: 30189342 DOI: 10.1016/j.cpr.2018.08.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 06/25/2018] [Accepted: 08/14/2018] [Indexed: 02/09/2023]
Affiliation(s)
| | - Trudie Chalder
- Academic Department of Psychological Medicine, King's College London, UK
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8
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Kaag AM, Reneman L, Homberg J, van den Brink W, van Wingen GA. Enhanced Amygdala-Striatal Functional Connectivity during the Processing of Cocaine Cues in Male Cocaine Users with a History of Childhood Trauma. Front Psychiatry 2018; 9:70. [PMID: 29593581 PMCID: PMC5857536 DOI: 10.3389/fpsyt.2018.00070] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 02/21/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND AND AIMS Childhood trauma is associated with increased levels of anxiety later in life, an increased risk for the development of substance use disorders, and neurodevelopmental abnormalities in the amygdala and frontostriatal circuitry. The aim of this study was to investigate the (neurobiological) link among childhood trauma, state anxiety, and amygdala-frontostriatal activity in response to cocaine cues in regular cocaine users. METHODS In this study, we included 59 non-treatment seeking regular cocaine users and 58 non-drug using controls. Blood oxygenation level-dependent responses were measured using functional magnetic resonance imaging while subjects performed a cue reactivity paradigm with cocaine and neutral cues. Psychophysiological interaction analyses were applied to assess functional connectivity between the amygdala and other regions in the brain. Self-report questionnaires were used to measure childhood trauma, state anxiety, drug use, drug use severity, and craving. RESULTS Neural activation was increased during the presentation of cocaine cues, in a widespread network including the frontostriatal circuit and amygdala in cocaine users but not in controls. Functional coupling between the amygdala and medial prefrontal cortex was reduced in response to cocaine cues, in both cocaine users and controls, which was further diminished with increasing state anxiety. Importantly, amygdala-striatal connectivity was positively associated with childhood trauma in regular cocaine users, while there was a negative association in controls. At the behavioral level, state anxiety was positively associated with cocaine use severity and craving related to negative reinforcement. CONCLUSION Childhood trauma is associated with enhanced amygdala-striatal connectivity during cocaine cue reactivity in regular cocaine users, which may contribute to increased habit behavior and poorer cognitive control. While we cannot draw conclusions on causality, this study provides novel information on how childhood trauma may contribute to the development and persistence of cocaine use disorder.
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Affiliation(s)
- Anne Marije Kaag
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands
- Departement of Psychiatry, Academic Medical Centre, Amsterdam, Netherlands
- Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands
| | - Liesbeth Reneman
- Departement of Radiology and Nuclear Medicine, Academic Medical Centre, Amsterdam, Netherlands
| | - Judith Homberg
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Medical Centre, Nijmegen, Netherlands
| | - Wim van den Brink
- Departement of Psychiatry, Academic Medical Centre, Amsterdam, Netherlands
| | - Guido A. van Wingen
- Departement of Psychiatry, Academic Medical Centre, Amsterdam, Netherlands
- Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands
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Tapia G, Marquebieille C, Delile JM, Othily E, Perez-Dandieu B. Symptômes dissociatifs et conduites à risques dans un cas de trouble de stress post-traumatique (TSPT) comorbide d’un trouble lié à l’usage de substances (TUS). EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2017. [DOI: 10.1016/j.ejtd.2017.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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10
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Bunford N, Wymbs BT, Dawson AE, Shorey RC. Childhood Maltreatment, Emotional Lability, and Alcohol Problems in Young Adults At-Risk for ADHD: Testing Moderation and Moderated Moderation. J Psychoactive Drugs 2017; 49:316-325. [DOI: 10.1080/02791072.2017.1325031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Nóra Bunford
- Postdoctoral Research Fellow, Institute of Biology, Department of Ethology, Eötvös Loránd University, Budapest, Hungary
| | - Brian T. Wymbs
- Assistant Professor of Psychology, Department of Psychology, Ohio University, Athens, OH, USA
| | - Anne E. Dawson
- Doctoral Student, Department of Psychology, Ohio University, Athens, OH, USA
| | - Ryan C. Shorey
- Assistant Professor of Psychology, Department of Psychology, Ohio University, Athens, OH, USA
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11
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Kok T, De Haan HA, Sensky T, van der Meer M, De Jong CAJ. Using the Pictorial Representation of Illness and Self Measure (PRISM) to Quantify and Compare Suffering From Trauma and Addiction. J Dual Diagn 2017; 13:101-108. [PMID: 28368709 DOI: 10.1080/15504263.2017.1293867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE In a sample of people with substance use disorder who had experienced psychological trauma, this study aimed to quantify differences in perceived suffering due to addiction-related problems and to trauma-related problems. METHODS The sample comprised 146 inpatients with substance use disorder: 25% had posttraumatic stress disorder (PTSD), 21% had subthreshold PTSD; and the remainder constituted the trauma-only group. PTSD, substance use disorder, and suffering were assessed using validated instruments. Suffering was measured using the Pictorial Representation of Illness and Self Measure (PRISM). RESULTS No differences were found among the PTSD, subthreshold PTSD, and trauma-only group in the suffering attributed to addiction-related problems. Those in the PTSD group appraised their suffering due to trauma-related problems as greater than the other groups. In the PTSD group, but not the subthreshold PTSD group, suffering due to trauma-related problems was appraised as greater than that due to addiction-related problems. CONCLUSIONS This is the first study to demonstrate quantitative comparisons between different health problems using the "common currency" of suffering. Our results indicate that even among those in an inpatient substance use disorder treatment program, comorbid PTSD may be more personally salient and cause greater suffering, with implications for therapeutic interventions available on substance use disorder treatment programs.
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Affiliation(s)
- Tim Kok
- a Tactus Addiction Treatment and Nijmegen Institute for Scientist-Practitioners in Addiction , Enschede , The Netherlands
| | - Hein A De Haan
- a Tactus Addiction Treatment and Nijmegen Institute for Scientist-Practitioners in Addiction , Enschede , The Netherlands
| | - Tom Sensky
- b Centre for Mental Health , Imperial College London , London , United Kingdom
| | | | - Cornelis A J De Jong
- a Tactus Addiction Treatment and Nijmegen Institute for Scientist-Practitioners in Addiction , Enschede , The Netherlands
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12
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Wiet S. Origins of Addiction Predictably Embedded in Childhood Trauma: A Neurobiological Review. Soa Chongsonyon Chongsin Uihak 2017. [DOI: 10.5765/jkacap.2017.28.1.4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Susie Wiet
- General, Child and Adolescent Psychiatrist, Addiction Medicine, Holistic Treament for Psychiatry Trauma Addiction, University of Utah-Adjunct Volunteer Faculty, Salt Lake City, UT, USA
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13
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Wolitzky-Taylor K, Sewart A, Vrshek-Schallhorn S, Zinbarg R, Mineka S, Hammen C, Bobova L, Adam EK, Craske MG. The Effects of Childhood and Adolescent Adversity on Substance Use Disorders and Poor Health in Early Adulthood. J Youth Adolesc 2016; 46:15-27. [PMID: 27613006 DOI: 10.1007/s10964-016-0566-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 08/30/2016] [Indexed: 01/21/2023]
Abstract
Childhood and adolescent adversity have been shown to predict later mental and physical health outcomes. Understanding which aspects and developmental timings of adversity are important, and the mechanisms by which they have their impact may help guide intervention approaches. A large subset of adolescents (N = 457; Female 68.9 %) from the 10-year longitudinal Youth Emotion Project was examined to better understand the associations among childhood/adolescent adversity, substance use disorder, and later health quality. Adolescent (but not childhood) adversities were associated with poorer health in late adolescence/early adulthood, adolescent adversities were associated with subsequent onset of substance use disorder, and adolescent adversities continued to be associated with poorer health in late adolescence/early adulthood after accounting for the variance explained by substance use disorder onset. These associations were observed after statistically accounting for emotional disorders and socioeconomic status. Specific domains of adversity uniquely predicted substance use disorder and poorer health outcomes. In contrast with current recent research, our findings suggest the association between childhood/adolescent adversity and poorer health outcomes in late adolescence and emerging adulthood are not entirely accounted for by substance use disorder, suggesting efforts to curtail family-based adolescent adversity may have downstream health benefits.
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Affiliation(s)
- Kate Wolitzky-Taylor
- Department of Psychiatry and Biobehavioral Sciences, University of California-Los Angeles, 11075 Santa Monica Blvd, Suite 200, Los Angeles, CA, 90025, USA
| | - Amy Sewart
- Department of Psychology, University of California-Los Angeles, 1285 Franz Hall-Box 951563, Los Angeles, CA, 90095, USA
| | - Suzanne Vrshek-Schallhorn
- Department of Psychology, University of North Carolina-Greensboro, 296 Eberhart Building, PO Box 26170
- Greensboro, NC 27402-6170, Greensboro, NC, 27412, USA
| | - Richard Zinbarg
- Department of Psychology, Northwestern University, 2029 Sheridan Road - 102 Swift Hall, Evanston, IL, 60208-2710, USA
| | - Susan Mineka
- Department of Psychology, Northwestern University, 2029 Sheridan Road - 102 Swift Hall, Evanston, IL, 60208-2710, USA
| | - Constance Hammen
- Department of Psychology, University of California-Los Angeles, 1285 Franz Hall-Box 951563, Los Angeles, CA, 90095, USA
| | - Lyuba Bobova
- Clinical Psychology, Adler University, 17 N. Dearborn Street, Chicago, IL, 60602, USA
| | - Emma K Adam
- School of Education and Social Policy and Institute for Policy Research, Northwestern University, 2120 Campus Drive, Evanston, IL, 60208, USA
| | - Michelle G Craske
- Department of Psychology, University of California-Los Angeles, 1285 Franz Hall-Box 951563, Los Angeles, CA, 90095, USA.
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Lotzin A, Haupt L, von Schönfels J, Wingenfeld K, Schäfer I. Profiles of Childhood Trauma in Patients with Alcohol Dependence and Their Associations with Addiction-Related Problems. Alcohol Clin Exp Res 2016; 40:543-52. [PMID: 26876715 DOI: 10.1111/acer.12990] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 12/14/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND The high occurrence of childhood trauma in individuals with alcohol dependence is well-recognized. Nevertheless, researchers have rarely studied which types of childhood trauma often co-occur and how these combinations of different types and severities of childhood trauma are related to the patients' current addiction-related problems. We aimed to identify childhood trauma profiles in patients with alcohol dependence and examined relations of these trauma profiles with the patients' current addiction-related problems. METHODS In 347 alcohol-dependent patients, 5 types of childhood trauma (sexual abuse, physical abuse, emotional abuse, emotional neglect, and physical neglect) were measured using the Childhood Trauma Questionnaire. Childhood trauma profiles were identified using cluster analysis. The patients' current severity of addiction-related problems was assessed using the European Addiction Severity Index. RESULTS We identified 6 profiles that comprised different types and severities of childhood trauma. The patients' trauma profiles predicted the severity of addiction-related problems in the domains of psychiatric symptoms, family relationships, social relationships, and drug use. CONCLUSIONS Childhood trauma profiles may provide more useful information about the patient's risk of current addiction-related problems than the common distinction between traumatized versus nontraumatized patients.
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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
| | - Lena Haupt
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
| | - Julia von Schönfels
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
| | - Katja Wingenfeld
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, 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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15
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Salokangas RKR, Schultze-Lutter F, Patterson P, von Reventlow HG, Heinimaa M, From T, Luutonen S, Hankala J, Kotimäki M, Tuominen L. Psychometric properties of the Trauma and Distress Scale, TADS, in an adult community sample in Finland. Eur J Psychotraumatol 2016; 7:30062. [PMID: 27032511 PMCID: PMC4816812 DOI: 10.3402/ejpt.v7.30062] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Revised: 02/18/2016] [Accepted: 02/22/2016] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND There is increasing evidence that a history of childhood abuse and neglect is not uncommon among individuals who experience mental disorder and that childhood trauma experiences are associated with adult psychopathology. Although several interview and self-report instruments for retrospective trauma assessment have been developed, many focus on sexual abuse (SexAb) rather than on multiple types of trauma or adversity. METHODS Within the European Prediction of Psychosis Study, the Trauma and Distress Scale (TADS) was developed as a new self-report assessment of multiple types of childhood trauma and distressing experiences. The TADS includes 43 items and, following previous measures including the Childhood Trauma Questionnaire, focuses on five core domains: emotional neglect (EmoNeg), emotional abuse (EmoAb), physical neglect (PhyNeg), physical abuse (PhyAb), and SexAb.This study explores the psychometric properties of the TADS (internal consistency and concurrent validity) in 692 participants drawn from the general population who completed a mailed questionnaire, including the TADS, a depression self-report and questions on help-seeking for mental health problems. Inter-method reliability was examined in a random sample of 100 responders who were reassessed in telephone interviews. RESULTS After minor revisions of PhyNeg and PhyAb, internal consistencies were good for TADS totals and the domain raw score sums. Intra-class coefficients for TADS total score and the five revised core domains were all good to excellent when compared to the interviewed TADS as a gold standard. In the concurrent validity analyses, the total TADS and its all core domains were significantly associated with depression and help-seeking for mental problems as proxy measures for traumatisation. In addition, robust cutoffs for the total TADS and its domains were calculated. CONCLUSIONS Our results suggest the TADS as a valid, reliable, and clinically useful instrument for assessing retrospectively reported childhood traumatisation.
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Affiliation(s)
| | - Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Paul Patterson
- Youthspace - Birmingham & Solihull Mental Health Foundation Trust, Birmingham, United Kingdom
| | - Heinrich Graf von Reventlow
- Ev. Zentrum für Beratung und Therapie am Weißen Stein, Evangelischer Regionalverband Frankfurt am Main, Frankfurt am Main, Germany
| | - Markus Heinimaa
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Tiina From
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Sinikka Luutonen
- Department of Psychiatry, University of Turku, Turku, Finland.,Psychiatric Clinic, Turku University Central Hospital, Åbo, Finland
| | - Juha Hankala
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Mika Kotimäki
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Lauri Tuominen
- Department of Psychiatry, University of Turku, Turku, Finland
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16
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Stress, sex, and addiction: potential roles of corticotropin-releasing factor, oxytocin, and arginine-vasopressin. Behav Pharmacol 2015; 25:445-57. [PMID: 24949572 DOI: 10.1097/fbp.0000000000000049] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Stress sensitivity and sex are predictive factors for the development of neuropsychiatric disorders. Life stresses are not only risk factors for the development of addiction but also are triggers for relapse to drug use. Therefore, it is imperative to elucidate the molecular mechanisms underlying the interactions between stress and drug abuse, as an understanding of this may help in the development of novel and more effective therapeutic approaches to block the clinical manifestations of drug addiction. The development and clinical course of addiction-related disorders do appear to involve neuroadaptations within neurocircuitries that modulate stress responses and are influenced by several neuropeptides. These include corticotropin-releasing factor, the prototypic member of this class, as well as oxytocin and arginine-vasopressin that play important roles in affiliative behaviors. Interestingly, these peptides function to balance emotional behavior, with sexual dimorphism in the oxytocin/arginine-vasopressin systems, a fact that might play an important role in the differential responses of women and men to stressful stimuli and the specific sex-based prevalence of certain addictive disorders. Thus, this review aims to summarize (i) the contribution of sex differences to the function of dopamine systems, and (ii) the behavioral, neurochemical, and anatomical changes in brain stress systems.
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17
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Kok T, de Haan H, van der Meer M, Najavits L, de Jong C. Assessing traumatic experiences in screening for PTSD in substance use disorder patients: what is the gain in addition to PTSD symptoms? Psychiatry Res 2015; 226:328-32. [PMID: 25687377 DOI: 10.1016/j.psychres.2015.01.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 01/16/2015] [Accepted: 01/18/2015] [Indexed: 10/24/2022]
Abstract
Traumatic experiences have been linked with substance use disorders (SUD) and may be an important factor in the perpetuation of SUD, even in the absence of posttraumatic stress disorder (PTSD) symptoms. The purpose of the current study was to examine the relationship between childhood trauma and substance use severity in 192 SUD inpatients. Childhood trauma was assessed using the Traumatic Experiences Checklist (TEC). With variables derived from this measure in addition to PTSD symptoms, two regression models were created with alcohol use or drug use severity as dependent variables. Alcohol severity was explained by PTSD symptoms as well as the age of trauma. Drug severity was explained solely by PTSD symptoms. The clinical value of assessing childhood trauma in determining the addiction severity appears to be limited in comparison with PTSD symptoms.
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Affiliation(s)
- Tim Kok
- Tactus Addiction Treatment, P.O. box 154, 7400 AD Deventer, The Netherlands; Nijmegen Institute for Scientist Practitioners in Addiction, P.O. box 6909, 6503 GK Nijmegen, The Netherlands.
| | - Hein de Haan
- Tactus Addiction Treatment, P.O. box 154, 7400 AD Deventer, The Netherlands; Nijmegen Institute for Scientist Practitioners in Addiction, P.O. box 6909, 6503 GK Nijmegen, The Netherlands.
| | | | - Lisa Najavits
- Veterans Affairs Boston Healthcare System and Boston University School of Medicine, 150 South Huntington Avenue, Boston, MA 02130, USA
| | - Cor de Jong
- Nijmegen Institute for Scientist Practitioners in Addiction, P.O. box 6909, 6503 GK Nijmegen, The Netherlands
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18
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Wolff N, Huening J, Shi J, Frueh BC, Hoover DR, McHugo G. Implementation and effectiveness of integrated trauma and addiction treatment for incarcerated men. J Anxiety Disord 2015; 30:66-80. [PMID: 25617774 PMCID: PMC4620997 DOI: 10.1016/j.janxdis.2014.10.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 10/27/2014] [Accepted: 10/30/2014] [Indexed: 11/17/2022]
Abstract
A controlled trial of Seeking Safety (SS) and Male-Trauma Recovery Empowerment Model (M-TREM) examined implementation and effectiveness of integrated group therapy for comorbid post-traumatic stress disorder (PTSD) and substance use disorder (SUD) on PTSD and mental health symptoms plus self-esteem and efficacy for incarcerated men. The study sample (n=230) was male inmates 18 years or older who were primarily non-white, high school graduates or equivalents, had childhood trauma histories, committed violent crimes, had serious mental illnesses, and resided in a maximum security prison. Incarcerated men, who screened positive for PTSD and SUD, were assigned randomly (n=142) or by preference (n=88) to receive SS or M-TREM, with a waitlist group of (n=93). Manualized interventions were group-administered for 14 weeks. Primary outcomes were PTSD and other mental health symptoms. Secondary outcomes were self-esteem, coping, and self-efficacy. SUD outcomes cannot be measured in a correctional setting. Implementation feasibility was exhibited by the ability to recruit, screen, assign, and retain participants. Effectiveness findings depended on sample, design, and method for analysis. Using a waitlist control group and no follow-up period, we found no aggregate effect of treatment on PTSD symptoms, although, when disaggregated, M-TREM was found to improve PTSD severity and SS improved general mental health symptoms and psychological functioning. Using intent-to-treat and completer analyses, no significant differences were found in the relative performance between SS and M-TREM on primary or secondary outcomes. When longitudinal data were maximized and modeled in ways that reflect the hierarchical nature of the data, we found that SS and M-TREM performed better than no treatment on PTSD severity and secondary outcomes, and that treatment benefits endured. Findings cautiously support implementing either Seeking Safety or M-TREM to treat incarcerated men with co-morbid PTSD and addiction problems.
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Affiliation(s)
- Nancy Wolff
- Center for Behavioral Health Services and Criminal Justice Research, Rutgers University, 176 Ryders Lane, New Brunswick, NJ 08901, United States.
| | - Jessica Huening
- Center for Behavioral Health Services and Criminal Justice Research, Rutgers University, 176 Ryders Lane, New Brunswick, NJ 08901, United States
| | - Jing Shi
- Center for Behavioral Health Services and Criminal Justice Research, Rutgers University, 176 Ryders Lane, New Brunswick, NJ 08901, United States
| | - B Christopher Frueh
- Department of Psychology, University of Hawaii, 200 W. Kawili St., Hilo, HI 96720, United States; The Menninger Clinic, Houston, TX 12303, United States
| | - Donald R Hoover
- Center for Behavioral Health Services and Criminal Justice Research, Rutgers University, 176 Ryders Lane, New Brunswick, NJ 08901, United States
| | - Gregory McHugo
- Dartmouth Psychiatric Research Center, The Geisel School of Medicine at Dartmouth, United States
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19
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Taha F, Galea S, Hien D, Goodwin RD. Childhood maltreatment and the persistence of smoking: a longitudinal study among adults in the US. CHILD ABUSE & NEGLECT 2014; 38:1995-2006. [PMID: 25466425 PMCID: PMC4448710 DOI: 10.1016/j.chiabu.2014.10.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 10/15/2014] [Accepted: 10/23/2014] [Indexed: 06/04/2023]
Abstract
The current study examined the relationship between childhood maltreatment-emotional, physical, and severe physical maltreatment-and the initiation and persistence of smoking. Data were drawn from the Midlife Development in the United States (MIDUS) Survey Waves 1 and 2. Frequency of childhood emotional, physical, and severe physical maltreatment (never, rare, intermittent, frequent) reported at Wave 1 was examined in relation to ever smoking, smoking daily, and persistent daily smoking at Waves 1 and 2. Logistic regression analyses were used to calculate odds ratios (with 95% confidence intervals), which were then adjusted for potential confounders. Childhood emotional, physical, and severe physical maltreatment were associated with increased odds of ever smoking, smoking daily, and persistent smoking at Waves 1 and 2. The majority of these associations remained significant after adjusting for confounding variables. These results suggest a history of trauma may play a prominent role in recalcitrant cigarette smoking and suggest that the success rates of treatments for smoking cessation may be improved by integrating trauma treatment where appropriate.
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Affiliation(s)
- Farah Taha
- Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY), 65-30 Kissena Boulevard, New York, NY 11367, USA
| | - Sandro Galea
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Denise Hien
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA; City University of New York, City College, New York, NY 10031, USA
| | - Renee D Goodwin
- Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY), 65-30 Kissena Boulevard, New York, NY 11367, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
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20
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Taplin C, Saddichha S, Li K, Krausz MR. Family history of alcohol and drug abuse, childhood trauma, and age of first drug injection. Subst Use Misuse 2014; 49:1311-6. [PMID: 24708431 DOI: 10.3109/10826084.2014.901383] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Childhood maltreatment may lead to development of future substance use; however the contributions of a family history of substance use is unclear. OBJECTIVES To better understand the relationship between childhood abuse, family history of alcohol and drug abuse, and injecting drug use initiation in a cohort of chronic opioid users. METHODS A cross-sectional survey of long-term and difficult to treat intravenous opiate users of the North American Opiate Medication Initiative (NAOMI) cohort was conducted in two Canadian cities (Vancouver and Montreal). For the analysis, we selected a subsample (n = 87) of the population reported experiencing childhood abuse and completed a 12-month follow up. The sample was 41.4% female and 14.9% First Nations, with a mean age of 38 years. This sample then completed the Childhood Trauma Questionnaire (CTQ) and the Addiction Severity Index (ASI) beside others. RESULTS Maternal alcohol and drug use was significantly associated with childhood sexual abuse, emotional abuse, and physical neglect. Paternal alcohol and drug use was significantly associated with childhood physical abuse. Increased severity of all types of childhood trauma was related to an earlier age of first injection. CONCLUSIONS/IMPORTANCE: Family history of drug and alcohol use is strongly associated with childhood trauma, which may, in turn, lead to an earlier initiation to the dangerous routes of drug injection.
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Affiliation(s)
- Chris Taplin
- 1Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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21
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Bosqui TJ, Shannon C, Tiernan B, Beattie N, Ferguson J, Mulholland C. Childhood trauma and the risk of violence in adulthood in a population with a psychotic illness. J Psychiatr Res 2014; 54:121-5. [PMID: 24694670 DOI: 10.1016/j.jpsychires.2014.03.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 03/10/2014] [Accepted: 03/12/2014] [Indexed: 10/25/2022]
Abstract
There are strong links between childhood trauma and the risk of violence (Ford et al., 2007). Despite evidence that people with psychotic disorders are at a higher risk of violence than the general population (Witt et al., 2013) there have been few studies that have examined the trauma-violence link in this population (Spidel et al., 2010). This study explored the association between a history of childhood trauma (abuse, neglect and conflict-related trauma) and the risk of violence in adults with psychotic disorders. The strongest associations with the risk of violence were found for sexual abuse (r = .32, p < .05) and the impact of community conflict (r = .32, p < .05). An accumulative effect of trauma was found using a hierarchical regression (adjusted R(2) = .14, F(2,37) = 4.23, p < .05). There are implications for applying models of violence to psychosis, risk assessment and treatment of people with psychotic disorders as well as informing trauma models and protective factors for children in conflict-affected regions.
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Affiliation(s)
- Tania Josiane Bosqui
- School of Psychology, Queens University Belfast, Belfast, BT7 1NN, Northern Ireland, UK.
| | - Ciarán Shannon
- School of Psychology, Queens University Belfast, Belfast, BT7 1NN, Northern Ireland, UK
| | - Bridget Tiernan
- School of Psychology, Queens University Belfast, Belfast, BT7 1NN, Northern Ireland, UK
| | - Nicola Beattie
- Shannon Clinic, Regional Forensic Unit, Knockbracken Health Care Park, Belfast, Northern Ireland, UK
| | - John Ferguson
- Shannon Clinic, Regional Forensic Unit, Knockbracken Health Care Park, Belfast, Northern Ireland, UK
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22
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Saban A, Flisher AJ, Grimsrud A, Morojele N, London L, Williams DR, Stein DJ. The association between substance use and common mental disorders in young adults: results from the South African Stress and Health (SASH) Survey. Pan Afr Med J 2014; 17 Suppl 1:11. [PMID: 24624244 PMCID: PMC3946226 DOI: 10.11694/pamj.supp.2014.17.1.3328] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 11/26/2013] [Indexed: 11/23/2022] Open
Abstract
Introduction Although substance use is commonly associated with mental disorders, limited data on this association are available from low and middle income countries such as South Africa. The aims of the study were i) to determine patterns of substance use in young adults, ii) to identify trends of common psychiatric disorders in relation to use of specific substances, and iii) to determine whether specific psychiatric disorders were associated with use of specific substances in the South African population. Methods Data were drawn from the South African Stress and Health (SASH) study, a nationally-representative, cross-sectional survey of South African households that forms part of a World Health Organisation (WHO) World Mental Health (WMH) initiative to standardise information on the global burden of mental illness and its correlates. Data from a subset (n = 1766; aged 18 to 30 years) of the SASH sample of 4351 individuals were analysed. The Composite International Diagnostic Interview Version 3 (CIDI 3.0) was used to elicit basic demographic details and information regarding mental illness and substance use. Multiple regression analyses, adjusted for age and gender, were used to identify associations between mental disorders and substance use. Results Significant associations were found between substance use and mood and anxiety disorders, with a particularly strong relationship between cannabis use and mental disorder. Conclusion The results are consistent with those from previous studies, and reinforce the argument that comorbid substance use and mental disorders constitute a major public health burden.
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Affiliation(s)
- Amina Saban
- Adolescent Health Research Unit, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa ; School of Public Health, University of Cape Town, Cape Town, Cape Town, South Africa
| | - Alan J Flisher
- Adolescent Health Research Unit, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Anna Grimsrud
- School of Public Health, University of Cape Town, Cape Town, Cape Town, South Africa
| | - Neo Morojele
- Alcohol and Drug Abuse Research Unit, Medical Research Council, Pretoria, South Africa
| | - Leslie London
- School of Public Health, University of Cape Town, Cape Town, Cape Town, South Africa
| | | | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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23
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Saban A, Flisher A, Laubscher R, London L, Morojele N. The association between psychopathology and substance use: adolescent and young adult substance users in inpatient treatment in Cape Town, South Africa. Pan Afr Med J 2014; 17 Suppl 1:8. [PMID: 24643118 PMCID: PMC3948364 DOI: 10.11694/pamj.supp.2014.17.1.3044] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 11/26/2013] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Evidence suggests that comorbid psychopathology can negatively affect treatment outcomes in substance users. In South Africa, limited information exists regarding the prevalence, nature and role of psychiatric comorbidity in substance users. This study examined psychiatric comorbidity and its association with specific substance use, and young adult substance users in treatment for substance use. METHODS Male and female inpatient substance users (n=95; ages 17-30 years) were sampled consecutively in order of admission from three clinics in Cape Town. An interview schedule was administered to elicit patients' sociodemographic and substance use history details. The computer-assisted Diagnostic Interview Schedule DSM IV (C-DIS IV) was administered to screen patients for current psychiatric disorders. RESULTS The sample was largely male, Coloured, Muslim and single. Cannabis (51.6%) and crystal methamphetamine (17.9%) were the most common first substances of use. Heroin (53.7%) and crystal methamphetamine (33.7%) were the most common substances for which treatment was sought (primary substances). The most common comorbid psychopathologies were anti-social personality disorder (ASPD 87.4%) and conduct disorder (CD 67.4%). Regression analyses showed a marginally significant association between specific phobia and first use of cannabis, but indicated no statistically significant associations between psychopathology and substance use. CONCLUSION The results demonstrated a high proportion of previously unidentified comorbid psychopathology in inpatient substance users. Further research is needed to investigate psychiatric comorbidity in inpatient substance users.
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Affiliation(s)
- Amina Saban
- Adolescent Health and Research Unit, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa,School of Public Health and Family Medicine, University of Cape Town, South Africa,Corresponding author: Dr.Amina Saban, Adolescent Health and Research Unit, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa and School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - Alan Flisher
- Adolescent Health and Research Unit, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa,Deceased
| | - Ria Laubscher
- Biostatistics Unit, Medical Research Council, Cape Town, South Africa
| | - Leslie London
- School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - Neo Morojele
- Alcohol and Drug Abuse Research Unit, Medical Research Council, Pretoria, South Africa
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Alper K, Shah J, Howard B, Roy John E, Prichep LS. Childhood abuse and EEG source localization in crack cocaine dependence. Psychiatry Res 2013; 213:63-70. [PMID: 23693089 DOI: 10.1016/j.pscychresns.2013.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2012] [Revised: 11/29/2012] [Accepted: 01/23/2013] [Indexed: 10/26/2022]
Abstract
Fourteen subjects with histories of sexual and/or physical abuse in childhood and 13 matched control subjects were selected from a consecutive series of clients in residential treatment for crack cocaine dependence. Standardized low-resolution electromagnetic brain tomography (sLORETA) was used to estimate the source generators of the EEG in a cortical mask with voxel z-scores referenced to normative data at frequency intervals of 039 Hz, with nonparametric permutation to correct by randomization for the number of comparisons and the intercorrelations and variance of distribution of voxel values. Subjects with histories of abuse in childhood had significantly greater EEG power than controls in the theta frequency range (3.51-7.41 Hz), with greatest differences in the 3.90-Hz band distributed mainly in the parahippocampal, fusiform, lingual, posterior cingulate, and insular gyri. The groups did not differ significantly with regard to delta (1.56-3.12 Hz), alpha (7.81-12.48 Hz), beta (12.87-19.89 Hz), and gamma (20.28-35.10 Hz) frequency power. In excess, theta EEG power, a bandwidth of transactions among hippocampus and amygdala and paralimbic and visual association cortex, may be a correlate of childhood exposure to abuse.
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Affiliation(s)
- Kenneth Alper
- Brain Research Laboratories, Department of Psychiatry, New York University School of Medicine, New York, NY 10016, USA.
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25
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McCauley JL, Killeen T, Gros DF, Brady KT, Back SE. Posttraumatic Stress Disorder and Co-Occurring Substance Use Disorders: Advances in Assessment and Treatment. ACTA ACUST UNITED AC 2012; 19. [PMID: 24179316 DOI: 10.1111/cpsp.12006] [Citation(s) in RCA: 170] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) are prevalent and frequently co-occur. Comorbid PTSD/SUD is associated with a more complex and costly clinical course when compared with either disorder alone, including increased chronic physical health problems, poorer social functioning, higher rates of suicide attempts, more legal problems, increased risk of violence, worse treatment adherence, and less improvement during treatment. In response, psychosocial treatment options have increased substantially over the past decade and integrated approaches - treatments that address symptoms of both PTSD and SUD concurrently -are fast becoming the preferred model for treatment. This paper reviews the prevalence, etiology and assessment practices as well as advances in the behavioral and pharmacologic treatment of comorbid PTSD and SUDs.
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26
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Bragdon RA, Lombardo TW. Written disclosure treatment for posttraumatic stress disorder in substance use disorder inpatients. Behav Modif 2012; 36:875-96. [PMID: 22826382 DOI: 10.1177/0145445512451273] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Comprehensive exposure-based approaches to treating posttraumatic stress disorder (PTSD) are effective, but they are time intensive and not widely used because of factors such as client noncompliance and fears of iatrogenic effects. Exposure by writing disclosure (WD), modeled after Pennebaker's brief stress-reduction procedure, may circumvent these obstacles. WD treatment reduces PTSD symptoms in trauma victims but has rarely been tested in diagnosed PTSD participants and never in substance use disorder (SUD) populations-despite high comorbidity rates. The authors applied a standard Pennebaker WD treatment for 45 SUD inpatients screened for full or subsyndromal PTSD in an uncontrolled study. Results suggested potential strong cost-effectiveness: Posttreatment outcome measures showed significant symptom reductions, which remained stable at 3-month follow-up. With converging evidence from future controlled studies, WD strategies may emerge as effective and easily implemented treatment options for PTSD in SUD treatment settings.
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A Multisite Study of the Association Between Emotion Dysregulation and Deliberate Self-harm Among Substance Use Disorder Inpatients. ADDICTIVE DISORDERS & THEIR TREATMENT 2011. [DOI: 10.1097/adt.0b013e318223fc9e] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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28
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Farrugia PL, Mills KL, Barrett E, Back SE, Teesson M, Baker A, Sannibale C, Hopwood S, Rosenfeld J, Merz S, Brady KT. Childhood trauma among individuals with co-morbid substance use and post traumatic stress disorder. ACTA ACUST UNITED AC 2011; 4:314-326. [PMID: 21984884 DOI: 10.1080/17523281.2011.598462] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND: Little is known about the impact of childhood trauma (CT) on the clinical profile of individuals with co-occurring substance use disorder (SUD) and post traumatic stress disorder (PTSD). AIMS: To compare the clinical characteristics of individuals with SUD+PTSD who have a history of CT with SUD+PTSD individuals who have experienced trauma during adulthood only. METHOD: Data were collected on 103 individuals as part of a randomised controlled trial examining the efficacy of an integrated psychosocial treatment for SUD+PTSD. Participants were recruited from substance use treatment services, community referrals and advertising. Data were collected on demographic characteristics, substance use and treatment histories, lifetime trauma exposure, and current physical and mental health functioning. RESULTS: The vast majority (77%) of the sample had experienced at least one trauma before the age of 16, with 55% of those endorsing childhood sexual abuse. As expected individuals with a CT history, as compared to without, evidenced significantly longer duration of PTSD. Those with a CT history also had more extensive lifetime trauma exposure, an earlier age of first intoxication, and reported more severe substance use (e.g., a greater number of drug classes used in their lifetime, higher severity of dependence scores and greater number of drug treatment episodes). CONCLUSION: Individuals with co-morbid SUD+PTSD who have experienced CT present with a more severe and chronic clinical profile in relation to a number of trauma and substance use characteristics, when compared to individuals with adulthood only trauma histories. It is therefore important for SUD+PTSD treatment planning that CT be carefully assessed.
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Logrip ML, Zorrilla EP, Koob GF. Stress modulation of drug self-administration: implications for addiction comorbidity with post-traumatic stress disorder. Neuropharmacology 2011; 62:552-64. [PMID: 21782834 DOI: 10.1016/j.neuropharm.2011.07.007] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Revised: 06/11/2011] [Accepted: 07/06/2011] [Indexed: 12/27/2022]
Abstract
Drug abuse and dependence present significant health burdens for our society, affecting roughly 10% of the population. Stress likely contributes to the development and persistence of drug use; for example, rates of substance dependence are elevated among individuals diagnosed with post-traumatic stress disorder (PTSD). Thus, understanding the interaction between stress and drug use, and associated neuroadaptations, is key for developing therapies to combat substance use disorders. For this purpose, many rodent models of the effects of stress exposure on substance use have been developed; the models can be classified according to three categories of stress exposure: developmental, adult nonsocial, and adult social. The present review addresses preclinical findings on the effect of each type of trauma on responses to and self-administration of drugs of abuse by focusing on a key exemplar for each category. In addition, the potential efficacy of targeting neuropeptide systems that have been implicated in stress responses and stress system neuroadaptation in order to treat comorbid PTSD and substance abuse will be discussed. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.
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Affiliation(s)
- Marian L Logrip
- Committee on the Neurobiology of Addictive Disorders, The Scripps Research Institute, 10550 North Torrey Pines Road, SP30-2400, La Jolla, CA 92037, USA.
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James R. Correlates of Sexual Self-Esteem in a Sample of Substance-Abusing Women. J Psychoactive Drugs 2011; 43:220-8. [DOI: 10.1080/02791072.2011.605700] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Golder S, Logan TK. Cumulative victimization, psychological distress, and high-risk behavior among substance-involved women. VIOLENCE AND VICTIMS 2011; 26:477-495. [PMID: 21882670 DOI: 10.1891/0886-6708.26.4.477] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This research addressed two questions: (a) What is the relationship between different patterns of cumulative victimization and psychological distress? And (b) How does the pattern of cumulative victimization and psychological distress influence women's engagement in substance- and sex-related risk behavior? Data were analyzed from interviews with 149 sexually active, crack-using women who completed a follow-up interview after participating in the Kentucky National Institute on Drug Abuse (NIDA) AIDS Cooperative Agreement. Findings from the multivariate analyses indicated that victimization accounted for 5% and 39% of the variance in psychological distress and high-risk behavior, respectively; cumulative victimization and psychological distress accounted for 6% to 11% of the variance in the high-risk behaviors. Results highlight the affects of childhood and adult victimization on psychological distress and the associations between different types of psychological distress and risk behavior.
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Affiliation(s)
- Seana Golder
- Kent School of Social Work, University of Louisville, Louisville, KY 40292, USA.
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The long-term effects of childhood maltreatment experiences on subsequent illicit drug use and drug-related problems in young adulthood. Addict Behav 2011; 36:95-102. [PMID: 20947260 DOI: 10.1016/j.addbeh.2010.09.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Revised: 09/14/2010] [Accepted: 09/17/2010] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The objective of this study was to examine the associations between (a) childhood maltreatment (i.e., physical abuse, sexual abuse, and neglect) and subsequent illicit drug use and (b) childhood maltreatment and drug-related problems in young adulthood. METHODS Wave 1 and Wave 3 public-use data from the National Longitudinal Study of Adolescent Health were used. Logistic regressions, controlling for adolescent drug use and other important family and peer contextual processes, were estimated to determine the associations between (a) childhood maltreatment experiences and subsequent illicit drug use and (b) childhood maltreatment and drug-related problems in young adulthood. RESULTS Among the participants, 31.9% reported some form of childhood maltreatment. Childhood physical abuse was associated with a 37% (OR=1.37; 95% CI=1.04, 1.80) increase in illicit drug use during the 30 days prior to the Wave 3 survey, a 48% (OR=1.48; 95% CI=1.16, 1.89) increase in illicit drug use during the year prior to the Wave 3 survey, and a 96% (OR=1.96; 95% CI=1.40, 2.76) increase in drug-related problems in young adulthood. The latter two associations persisted even after controlling for illicit drug use in adolescence. Neglect among females was associated with a higher likelihood of past year illicit drug use in young adulthood (OR=1.31; 95% CI=1.002, 1.71). However, this association was not significant once the effect of illicit drug use in adolescence was statistically controlled for. CONCLUSIONS The present findings suggest that childhood maltreatment is related to subsequent illicit drug use and drug-related problems in young adulthood and that some of these associations differ by gender. Implications for preventive intervention are discussed.
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Nash DL, Wilkinson J, Paradis B, Kelley S, Naseem A, Grant KM. Trauma and substance use disorders in rural and urban veterans. J Rural Health 2010; 27:151-8. [PMID: 21457307 DOI: 10.1111/j.1748-0361.2010.00326.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
CONTEXT Disparities in the prevalence, morbidity, and mortality of multiple mental health conditions have been described between rural and urban populations. However, there is limited information regarding differences in exposure to trauma and trauma-related mental health conditions in these populations. Given the number of veterans who are returning to rural communities after serving in Operation Enduring Freedom and Operation Iraqi Freedom, differences in trauma exposure are of particular relevance. Trauma exposure is related to a variety of mental health disorders including substance use disorders (SUD). PURPOSE The objectives of this preliminary study were to describe lifetime military and nonmilitary trauma and to compare trauma history between rural and urban veterans in SUD treatment. METHODS Sixty adults in SUD treatment were enrolled at 3 Veterans Health Administration sites in Nebraska over a 3-month period in 2008. Subjects completed an interview with study staff, which assessed SUD diagnoses and childhood, lifetime, and military trauma. Rural or urban status was determined by self-report of childhood residence. Childhood trauma, lifetime trauma, and response to military trauma were compared between rural and urban veterans. FINDINGS Although there were no significant differences in trauma exposure between rural and urban groups, there was an association between specific types of trauma and measures typically associated with increased substance abuse severity and poorer SUD treatment outcome. CONCLUSION This is the first study, to our knowledge, which compared trauma exposure between rural and urban veterans and identified an association between childhood trauma exposure and multiple SUD treatment attempts.
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Affiliation(s)
- David L Nash
- Creighton University School of Medicine, Omaha, Nebraska, USA
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van Dam D, Ehring T, Vedel E, Emmelkamp PM. Validation of the Primary Care Posttraumatic Stress Disorder screening questionnaire (PC-PTSD) in civilian substance use disorder patients. J Subst Abuse Treat 2010; 39:105-13. [DOI: 10.1016/j.jsat.2010.05.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Revised: 04/16/2010] [Accepted: 05/03/2010] [Indexed: 11/25/2022]
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Fountoulakis KN. The emerging modern face of mood disorders: a didactic editorial with a detailed presentation of data and definitions. Ann Gen Psychiatry 2010; 9:14. [PMID: 20385020 PMCID: PMC2865463 DOI: 10.1186/1744-859x-9-14] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Accepted: 04/12/2010] [Indexed: 12/17/2022] Open
Abstract
The present work represents a detailed description of our current understanding and knowledge of the epidemiology, etiopathogenesis and clinical manifestations of mood disorders, their comorbidity and overlap, and the effect of variables such as gender and age. This review article is largely based on the 'Mood disorders' chapter of the Wikibooks Textbook of Psychiatry http://en.wikibooks.org/wiki/Textbook_of_Psychiatry/Mood_Disorders.
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Briand LA, Blendy JA. Molecular and genetic substrates linking stress and addiction. Brain Res 2009; 1314:219-34. [PMID: 19900417 DOI: 10.1016/j.brainres.2009.11.002] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Revised: 11/02/2009] [Accepted: 11/03/2009] [Indexed: 12/19/2022]
Abstract
Drug addiction is one of the top three health concerns in the United States in terms of economic and health care costs. Despite this, there are very few effective treatment options available. Therefore, understanding the causes and molecular mechanisms underlying the transition from casual drug use to compulsive drug addiction could aid in the development of treatment options. Studies in humans and animal models indicate that stress can lead to both vulnerability to develop addiction, and increased drug taking and relapse in addicted individuals. Exposure to stress or drugs of abuse results in long-term adaptations in the brain that are likely to involve persistent alterations in gene expression or activation of transcription factors, such as the cAMP Response Element Binding (CREB) protein. The signaling pathways controlled by CREB have been strongly implicated in drug addiction and stress. Many potential CREB target genes have been identified based on the presence of a CRE element in promoter DNA sequences. These include, but are not limited to CRF, BDNF, and dynorphin. These genes have been associated with initiation or reinstatement of drug reward and are altered in one direction or the other following stress. While many reviews have examined the interactions between stress and addiction, the goal of this review was to focus on specific molecules that play key roles in both stress and addiction and are therefore posed to mediate the interaction between the two. Focus on these molecules could provide us with new targets for pharmacological treatments for addiction.
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Affiliation(s)
- Lisa A Briand
- Department of Pharmacology, The University of Pennsylvania School of Medicine, TRL, 125 South 31(st) Street, USA
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Bornovalova MA, Ouimette P, Crawford AV, Levy R. Testing gender effects on the mechanisms explaining the association between post-traumatic stress symptoms and substance use frequency. Addict Behav 2009; 34:685-92. [PMID: 19423233 DOI: 10.1016/j.addbeh.2009.04.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2009] [Revised: 03/18/2009] [Accepted: 04/09/2009] [Indexed: 11/19/2022]
Abstract
The present study examines gender differences in the mechanisms that explain the association between PTSD symptoms and substance use frequency in a sample of 182 urban substance users. Specifically, the current study examined gender differences in the role of two potential explanatory variables, namely, difficulties controlling impulsive behavior when distressed (IMP), and a lack of emotional awareness and clarity (AW/CLAR). Multiple-group path modeling (across males and females) was used to examine gender differences in the path coefficients from PTSD symptoms to IMP and AW/CLAR, and from these latter variables to drug use frequency. Results indicated that PTSD symptoms were associated with IMP and AW/CLAR, and these path coefficients did not vary by gender. However, gender differences emerged when considering the path coefficients from AW/CLAR and IMP to substance use frequency. Specifically, for women, the association between PTSD and substance use was partially explained by IMP, whereas for men, the association between PTSD and substance use was partially explained by AW/CLAR. The current study is the first to examine gender differences in mechanisms accounting for the association between PTSD and substance use frequency, and these results also support the value and importance of examining gender differences in mechanisms underlying PTSD-SUD comorbidity.
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Affiliation(s)
- Marina A Bornovalova
- University of Minnesota, Department of Psychology, N218 Elliott Hall, 75 East River Road, Minneapolis, MN 55455-0344, United States.
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Martínez-Raga J, Keaney F, Marshall EJ, Ball D, Best D, Strang J. Positive or negative history of childhood sexual abuse among problem drinkers: relationship to substance use disorders and psychiatric co-morbidity. JOURNAL OF SUBSTANCE USE 2009. [DOI: 10.1080/14659890110110356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Evren C, Evren B, Dalbudak E, Ozcelik B, Oncu F. Childhood abuse and neglect as a risk factor for alexithymia in adult male substance dependent inpatients. J Psychoactive Drugs 2009; 41:85-92. [PMID: 19455912 DOI: 10.1080/02791072.2009.10400677] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The prevalence of childhood abuse and neglect (CAN) histories and their associations with alexithymia among male substance-dependent inpatients were studied. Participants were 159 consecutively admitted male substance dependents (115 alcohol and 44 other drugs). Substance dependence was diagnosed by means of the Structured Clinical Interview for DSM-IV (SCID-I), Turkish version. Patients were investigated with the Toronto Alexithymia Scale (TAS-20) and Childhood Abuse and Neglect Questionnaire. Among substance-dependent patients, 57.0% had at least one type of CAN and 45.3% were considered as alexithymic since they had a score greater than 60 on the TAS-20. Rate of unemployment, low educational status, emotional abuse and history of suicide attempts were higher in alexithymic substance dependent patients. Those who had histories of two or more types of childhood abuse or neglect had also higher mean score on TAS-20, particularly on the item "difficulty in identifying feelings-DIF." Also, the number of childhood trauma types was positively correlated with TAS-20 and DIF and the "difficulty in describing feelings-DDF" items of TAS-20. History of childhood emotional abuse was the only determinant for alexithymia. Childhood emotional abuse might be a risk factor for alexithymia among inpatient substance dependents.
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Affiliation(s)
- Cuneyt Evren
- Bakirkoy State Hospital for Psychiatric and Neurological Disorders, Research, Treatment and Training Center Alcohol and Drug use Disorders (AMATEM), Istanbul, Turkey
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Sansone RA, Whitecar P, Wiederman MW. The prevalence of childhood trauma among those seeking buprenorphine treatment. J Addict Dis 2009; 28:64-7. [PMID: 19197597 DOI: 10.1080/10550880802545101] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
In this study, the authors examined the prevalence of five types of childhood trauma among a sample of adult patients who were addicted to opioids and seeking treatment with buprenorphine. Using a survey methodology, the authors examined a consecutive sample of 113 participants and found that 20.4% reported having experienced sexual abuse, 39.8% reported having experienced physical abuse, 60.2% reported having experienced emotional abuse, 23.0% reported having experienced physical neglect, and 65.5% reported having witnessed violence. Only 19.5% of the sample denied having experienced any of the five forms of childhood trauma. Most respondents (60.2%) reported having experienced one, two, or three different forms of childhood trauma. A minority reported having experienced four (13.3%) or all five (7.1%) forms of childhood trauma. These data indicate that among individuals with opioid dependence who are seeking treatment with buprenorphine, the prevalence rates of various types of childhood trauma are quite high.
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Affiliation(s)
- Randy A Sansone
- Department of Psychiatry, Wright State University School of Medicine, Dayton, Ohio, USA.
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41
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Dunlap E, Golub A, Johnson BD, Benoit E. Normalization of violence: experiences of childhood abuse by inner-city crack users. J Ethn Subst Abuse 2009; 8:15-34. [PMID: 19266372 DOI: 10.1080/15332640802683359] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
An increasing literature mostly based on retrospective surveys has been consistently documenting a correlation between physical abuse in childhood (CPA) and substance abuse in adulthood (ASA). This article uses ethnographic data to reveal the processes behind and context of this linkage for one population-poor, inner-city New York residents who became crack users. Life in the inner city is qualitatively different than in more fortunate circumstances. CPA is but one of numerous stressors and factors contributing to ASA. Approximately half of the subjects reported clear recollections of being physically beaten by their mothers or their various male partners. Although several denied being beaten in childhood, they typically reported various forms of physical assaults that they "deserved." Physical assaults, especially by mothers, were often understood as expressions of love. As such, these respondents viewed their ongoing physical assaults as an ordinary part of their childhood and adolescence. Such physical punishment also socialized and prepared children for the violence that would likely occur during their childhood in their inner-city communities. This analysis highlights how reducing substance abuse in the inner city may require a much more comprehensive effort than a focus on reducing CPA. These findings also have important implications for quantitative research regarding CPA and ASA. Such studies should subdivide their analyses by socioeconomic status to more clearly measure how much of a risk factor CPA represents among wealthier populations and how much not being abused may serve as a protective factor among poor inner-city populations.
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Affiliation(s)
- Eloise Dunlap
- National Development and Research Institutes, New York, New York, USA
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42
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Frisman L, Ford J, Lin HJ, Mallon S, Chang R. Outcomes of Trauma Treatment Using the TARGET Model. ACTA ACUST UNITED AC 2008. [DOI: 10.1080/15560350802424910] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Linda Frisman
- a Connecticut Department of Mental Health and Addiction Services
- b University of Connecticut , 410 Capitol Avenue, MS # 14 RSD, PO Box 341431, Hartford , CT
| | - Julian Ford
- c University of Connecticut Health Center , Farmington , CT
| | - Hsiu-Ju Lin
- d Research Division , Connecticut Department of Mental Health and Addiction Services
| | - Sharon Mallon
- e Pathways Center for Learning & Behavioral Health , Essex , CT
| | - Rocío Chang
- f Department of Psychiatry , University of Connecticut School of Medicine
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De Sanctis VA, Trampush JW, Harty SC, Marks DJ, Newcorn JH, Miller CJ, Halperin JM. Childhood maltreatment and conduct disorder: independent predictors of adolescent substance use disorders in youth with attention deficit/hyperactivity disorder. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2008; 37:785-93. [PMID: 18991129 PMCID: PMC2628748 DOI: 10.1080/15374410802359650] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Children with attention deficit/hyperactivity disorder (ADHD) are at heightened risk for maltreatment and later substance use disorders (SUDs). We investigated the relationship of childhood maltreatment and other risk factors to SUDs among adolescents diagnosed with ADHD in childhood. Eighty adolescents diagnosed with ADHD when they were 7 to 11 years old were screened for histories of childhood maltreatment, and SUD diagnoses were formulated in accordance with the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders. Lifetime history of problematic substance use was obtained for each parent at baseline. Childhood maltreatment predicted SUD outcome over and above that accounted for by childhood conduct disorder and problematic parental substance use, two potent predictors of adolescent SUDs.
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44
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Andersen SL, Teicher MH. Desperately driven and no brakes: developmental stress exposure and subsequent risk for substance abuse. Neurosci Biobehav Rev 2008; 33:516-24. [PMID: 18938197 DOI: 10.1016/j.neubiorev.2008.09.009] [Citation(s) in RCA: 204] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2008] [Revised: 09/15/2008] [Accepted: 09/17/2008] [Indexed: 11/29/2022]
Abstract
Adverse life events are associated with a wide range of psychopathology, including an increased risk for substance abuse. In this review, we focus on the inter-relationship between exposure to adversity and brain development, and relate this to enhanced windows of vulnerability. This review encompasses clinical and preclinical data, drawing evidence from epidemiological studies, morphometric and functional imaging studies, and molecular biology and genetics. The interaction of exposure during a sensitive period and maturational events produces a cascade that leads to the initiation of substance use at younger ages, and increases the likelihood of addiction by adolescence or early adulthood. A stress-incubation/corticolimbic dysfunction model is proposed based on the interplay of stress exposure, development stage, and neuromaturational events that may explain the seeking of specific classes of drugs later in life. Three main factors contribute to this age-based progression of increased drug use: (1) a sensitized stress response system; (2) sensitive periods of vulnerability; and (3) maturational processes during adolescence. Together, these factors may explain why exposure to early adversity increases risk to abuse substances during adolescence.
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Affiliation(s)
- Susan L Andersen
- Developmental Biopsychiatry Research Program, McLean Hospital/Harvard Medical School, Belmont, MA 02478, USA.
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45
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Brown VB, Najavits LM, Cadiz S, Finkelstein N, Heckman JP, Rechberger E. Implementing an evidence-based practice: Seeking Safety Group. J Psychoactive Drugs 2008; 39:231-40. [PMID: 18159776 DOI: 10.1080/02791072.2007.10400609] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This article presents findings from a multisite study on adopting and implementing an evidence-based practice, Seeking Safety, for women with co-occurring disorders and experiences of physical and sexual abuse. It focuses on what implementation decisions different sites made to optimize the compatibility of Seeking Safety with the site's needs and experiences and on issues posed by Rogers (1995) as relevant to successful diffusion of an innovative practice. A total of 157 clients and 32 clinicians reported on satisfaction with various aspects of the model. Cross-site differences are also examined. Results show that Seeking Safety appears to be an intervention that clinicians perceive as highly relevant to their practice, and one that adds value. Clients perceive the treatment as uniquely touching on their needs in a way that previous treatments had not.
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Affiliation(s)
- Vivian B Brown
- PROTOTYPES, Centers for Innovation in Health, Mental Health, and Social Services, Los Angeles, CA, USA.
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46
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Michaels CC, Holtzman SG. Early postnatal stress alters place conditioning to both mu- and kappa-opioid agonists. J Pharmacol Exp Ther 2008; 325:313-8. [PMID: 18203949 DOI: 10.1124/jpet.107.129908] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Clinical literature has established a link between early childhood incidents of neglect and trauma and adult problems with substance abuse. In rats, such early life stress has been modeled using a maternal separation (MS) paradigm in which rat pups were removed from their mothers for a few hours daily during the first two postnatal weeks. In this study, we used the MS model to investigate the effects of early postnatal stress on place conditioning to both mu- and kappa-opioid agonists in male and female Long-Evans rats. Offspring of both rearing conditions [MS or nonhandled (NH)] were conditioned using a biased procedure to saline, the mu-opioid agonist morphine (3.0, 5.6, and 10 mg/kg s.c.), or the kappa-opioid agonist spiradoline (0.3, 1.0, and 3.0 mg/kg) for 3 days, followed by a drug-free place-conditioning test 24 h later. Saline was administered in the morning, 30 min before confinement in one compartment, whereas morphine or spiradoline was administered in a similar manner 6 h later in the opposite compartment. MS offspring spent significantly more time in the morphine-paired compartment than NH offspring, indicating a greater place preference for the mu-opioid agonist. In the case of spiradoline, NH offspring spent significantly less time in the spiradoline-paired compartment, indicating a greater aversion to the kappa-opioid agonist in these animals than in MS offspring. These findings indicate that early postnatal stress can significantly alter the rewarding or aversive value of mu- and kappa-opioid agonists when measured using place conditioning.
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Affiliation(s)
- Clifford C Michaels
- Emory University, Department of Pharmacology, 1510 Clifton Road, Suite 5074, Atlanta, GA 30322.
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47
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Peirce JM, Kindbom KA, Waesche MC, Yuscavage ASE, Brooner RK. Posttraumatic stress disorder, gender, and problem profiles in substance dependent patients. Subst Use Misuse 2008; 43:596-611. [PMID: 18393079 DOI: 10.1080/10826080701204623] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Patients with a chronic and severe substance-use disorder who also have a history of posttraumatic stress disorder (PTSD) are thought to have a unique set of problems. The present study assessed psychiatric disorders, psychosocial problems, and traumatic events with structured interviews in 747 men and 693 women enrolling in urban opioid substitution treatment programs from 1995 to 2001. Participants with versus without a history of PTSD were more likely to have a history of many other psychiatric disorders and demonstrated more current and historical medical, employment, family/social, and psychiatric problems. PTSD was generally unrelated to substance-use disorder severity or diagnoses, with the exception of an increased risk of alcohol dependence. Women were more likely than men to have experienced sexual assault, and less likely to have been physically assaulted, although these events precipitated PTSD at equivalent rates across gender. In contrast, witnessing or hearing about the death or injury of others was more likely to precipitate PTSD in women than men. Female gender, exposure to combat, sexual assault, or physical assault, and a history of major mood or anxiety disorder were the best predictors of PTSD in this group. Study limitations are noted.
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Affiliation(s)
- Jessica M Peirce
- Addiction Treatment Services, Johns Hopkins Bayview Medical Center, Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21224, USA.
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Caprioli D, Celentano M, Paolone G, Badiani A. Modeling the role of environment in addiction. Prog Neuropsychopharmacol Biol Psychiatry 2007; 31:1639-53. [PMID: 17889978 DOI: 10.1016/j.pnpbp.2007.08.029] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The aim of this review is to provide an overview of the main types of animal models used to investigate the modulatory role of environment on drug addiction. The environment can alter the responsiveness to addictive drugs in at least three major ways. First, adverse life experiences can make an individual more vulnerable to develop drug addiction or to relapse into drug seeking. Second, neutral environmental cues can acquire, through Pavlovian conditioning, the ability to trigger drug seeking even after long periods of abstinence. Third, the environment immediately surrounding drug taking can alter the behavioral, subjective, and rewarding effects of a given drug, thus influencing the propensity to use the same drug again. We have focused in particular on the results obtained using an animal model we have developed to study the latter type of drug-environment interaction.
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Affiliation(s)
- Daniele Caprioli
- Department of Human Physiology and Pharmacology, University of Rome Sapienza, Rome, Italy
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49
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Michaels CC, Easterling KW, Holtzman SG. Maternal separation alters ICSS responding in adult male and female rats, but morphine and naltrexone have little affect on that behavior. Brain Res Bull 2007; 73:310-8. [PMID: 17562397 DOI: 10.1016/j.brainresbull.2007.04.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2006] [Revised: 04/17/2007] [Accepted: 04/26/2007] [Indexed: 10/23/2022]
Abstract
Prior research has provided evidence that the early postnatal environment can have long lasting effects on both the physiology and behavior of offspring. This is modeled in rats by using a maternal separation paradigm in which pups are separated from their mother for a few hours daily during their first two postnatal weeks. While this model has been used extensively to study stress effects and anxiety, less research has been done to examine how these separations affect measures of reward and reinforcement in adulthood. The current study investigated the impact of maternal separation (MS) on intracranial self-stimulation (ICSS) maintained responding in male and female offspring, and the effects of morphine (0.3-3.0 mg/kg) and naltrexone (0.1-10 mg/kg) on that responding. Rearing condition (MS or non-handled, NH) significantly altered response rates during acquisition in both sexes, with NH offspring exhibiting the highest rates. Group differences in baseline responding on a progressive ratio (PR-2) schedule of reinforcement were evident only in females, with MS females having response rates 50% lower than NH females. Neither morphine nor naltrexone differentially affected either rearing group. Sex impacted NH offspring: males acquired responding more readily, but females had higher response rates and breakpoints during all other phases of the experiment. In MS offspring, no sex differences were observed during acquisition, but during all other phases males had higher response rates and breakpoints than females. These results indicate that maternal separation during the first two postnatal weeks can have long-term effects on responding for ICSS, but these effects do not appear tied to endogenous opioid systems in the lateral hypothalamus.
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Affiliation(s)
- Clifford C Michaels
- Department of Pharmacology, Emory University School of Medicine, Atlanta, GA 30322, USA.
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50
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Dragan M, Lis-Turlejska M. Prevalence of posttraumatic stress disorder in alcohol dependent patients in Poland. Addict Behav 2007; 32:902-11. [PMID: 16857322 DOI: 10.1016/j.addbeh.2006.06.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2006] [Revised: 05/23/2006] [Accepted: 06/07/2006] [Indexed: 10/24/2022]
Abstract
The present study investigates the prevalence of comorbid posttraumatic stress disorder (PTSD) in a sample of Polish alcohol dependent patients and examines the relationship between comorbid PTSD and alcohol use-related problems. Patients (n=458) were recruited from randomly chosen clinical settings and were administered self-report measures of trauma exposure, PTSD symptomatology, and alcohol use-related problems. From this sample, 67% of the patients reported having experienced at least one criterion A traumatic event, and 60% of them reported multiple traumas. Approximately 25% of them met the criteria for current PTSD. The only significant difference between the PTSD and non-PTSD groups was abuse/dependence of other psychoactive substances. However, patients reporting physical assaults committed by a non-stranger reported more frequent PTSD diagnosis, more extensive symptomatology, more conflicts with the law and more physical injuries due to drinking. The findings of the study confirm the importance of assessing trauma and PTSD in alcohol dependent patients.
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Affiliation(s)
- Małgorzata Dragan
- Faculty of Psychology, Warsaw University, ul. Stawki 5/7, 00-183 Warsaw, Poland.
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