Profiles of Childhood Trauma in Women With Substance Use Disorders and Comorbid Posttraumatic Stress Disorders
Profiles of Childhood Trauma in Women With Substance Use Disorders and Comorbid Posttraumatic Stress Disorders
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DOI：
10.3389/fpsyt.2019.00674
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发表时间：
2019-10-18
影响因子：
4.7
通讯作者：
Schaefer, Ingo
中科院分区：
文献类型：
--
作者：
Lotzin, Annett;Grundmann, Johanna;Schaefer, Ingo
背景：人们越来越认识到物质使用障碍，包括物质滥用和物质依赖，与儿童创伤和创伤后应激障碍密切相关。在有药物使用障碍的妇女中，大多数报告遭受性、身体或精神虐待或忽视。然而，目前尚不清楚哪些类型的儿童创伤会同时发生在患有物质使用障碍的妇女身上，以及不同类型和严重程度的儿童创伤的组合如何与临床特征相关。这一信息对药物使用障碍的治疗具有重要意义。目的：本研究的第一个目的是调查女性物质使用障碍和创伤后应激障碍患者的童年创伤概况。第二个目的是检查这些童年创伤概况与成瘾特征或当前临床症状之间的关系。方法：根据DSM-IV，我们纳入了343名寻求药物使用障碍和共病创伤后应激障碍治疗的女性。使用《儿童创伤问卷》对儿童期创伤的五种类型（性虐待、身体虐待、精神虐待）进行了测量。使用成瘾严重程度指数-生活评估成瘾特征。当前临床症状的严重程度由症状检查表27确定。隐性特征分析用于区分儿童创伤的特征。方差分析用于检验儿童创伤概况与成瘾特征或临床症状严重程度之间的关系。结果：十分之九的女性报告至少有一种类型的童年虐待或忽视。可以区分出四种不同的儿童创伤特征，这些特征表征了不同类型和严重程度的儿童创伤：“低创伤”；“中度性虐待和精神虐待”；“严重的性虐待和精神虐待”；以及“所有类型创伤的严重程度”。儿童期创伤程度越严重的人，开始使用药物和逐渐使用药物的年龄越早。此外，童年创伤档案与当前抑郁症状、心境恶劣症状、社交恐惧症症状和不信任的严重程度有关。结论：在患有物质使用障碍和创伤后应激障碍的女性中，童年创伤档案可以告知成瘾特征和广泛临床症状的严重程度。这些信息对于了解当前的治疗需求至关重要，应该对有物质使用障碍和创伤暴露的妇女进行系统评估。
Background: It is increasingly becoming accepted that substance use disorders, including substance abuse and substance dependence, are closely related to childhood trauma and posttraumatic stress disorders. Among women with substance use disorders, the majority report sexual, physical or emotional abuse, or neglect. However, it is poorly understood which types of childhood trauma co-occur in women with substance use disorders and how combinations of different types and severities of childhood trauma are related to clinical characteristics. This information is important to inform treatment of substance use disorders. Aim: The first aim of this research was to investigate profiles of childhood trauma in female patients with substance use disorders and posttraumatic stress disorders. The second aim was to examine relationships between these childhood trauma profiles and addiction characteristics or current clinical symptoms. Methods: We includeda 343 treatment-seeking women with substance use disorders and comorbid posttraumatic stress disorders according to DSM-IV. Five types of childhood trauma (sexual abuse, physical abuse, emotional abuse) were measured using the Childhood Trauma Questionnaire. Addiction characteristics were assessed by using the Addiction Severity Index-lite. Current severity of clinical symptoms was determined by the Symptom-Checklist-27. Latent profile analysis was conducted to distinguish profiles of childhood trauma. Analysis of variance was applied to examine the relationship between childhood trauma profiles and addiction characteristics or severity of clinical symptoms. Results: Nine out of ten women reported at least one type of childhood abuse or neglect. Four different childhood trauma profiles could be distinguished that characterized different types and severities of childhood trauma: 'Low trauma'; 'Moderate sexual abuse and emotional abuse'; 'Severe sexual abuse and emotional abuse'; and 'Severe levels of all types of trauma'. Profiles with more severe levels of childhood trauma showed an earlier age at initiation and escalation of substance use. Furthermore, childhood trauma profiles were related to current severity of depressive symptoms, dysthymic symptoms, sociophobic symptoms, and distrust. Conclusion: In women with substance use disorders and posttraumatic stress disorders, childhood trauma profiles can inform about addiction characteristics and severity of a wide range of clinical symptoms. This information is essential to understand current treatment needs and should be systematically assessed in women with substance use disorders and trauma exposure.