Impact of Trauma on Substance Abusing Homeless Men

描述（由申请人提供）：拟议的为期两年的项目建立在早期的探索性研究，调查了无家可归的精神疾病患者的受害率。该项目致力于通过检查创伤与物质使用/滥用的关系来加强物质滥用研究和实践，同时控制其他已知的预测因素（即精神健康障碍，生活压力和健康状况不佳）。这项研究将收集大约290名无家可归者的数据，了解他们在生活中遭受创伤的程度，以及他们是否滥用或误用酒精或其他物质。北卡罗来纳州威克县的两个机构已经同意协助确定这项研究的候选人。合作机构向无家可归男子提供的服务类型各不相同，从而有助于确保对无家可归男子人口进行广泛抽样。其中包括一个无家可归者收容所，为倾向于积极使用毒品的男性提供服务，以及一个住院药物滥用治疗机构，男性在那里短期清醒。这种安排将提供一种方法来比较在药物滥用和无家可归的不同阶段的男子的创伤史的相似性和/或差异。为了说明创伤对药物滥用的影响，数据将用于拟合因果（即时间排序，路径分析）模型，该模型将新的视角，历史序列与假设用于预测药物滥用/误用的因素相结合。该项目将有助于我们理解创伤在加剧滥用和滥用酒精和其他物质的倾向中的作用，控制诸如精神健康障碍和生活压力等因素。该项目还将向指导实践的决策者提供信息，以便能够更全面和全面地为使用/滥用药物者提供服务。

DESCRIPTION (provided by applicant): The proposed two-year project builds on an earlier exploratory study that investigated the prevalence of victimization among homeless men with mental illness. This project strives to enhance substance abuse research and practice by examining the relationship of trauma to substance use/misuse when controlling for other known predictors (i.e. mental health disorders, life stressors, and poor health). This study will collect data from approximately 290 homeless men concerning the extent to which they have experienced trauma in their lives and whether or not they abuse or misuse alcohol or other substances. Two agencies in Wake County, North Carolina, have agreed to assist in identifying candidates for the study. The cooperating agencies vary in the types of services they provide to homeless men, thereby helping to ensure a broad sample of the homeless male population. They include a homeless shelter that serves men who tend be actively using drugs, and an in-patient substance abuse treatment facility where men have short-term sobriety. This arrangement will provide a way to compare the similarities and/or differences in trauma histories for men at varying stages of substance abuse and homelessness. To make statements about the impact of trauma on substance abuse, the data will be used to fit a causal (i.e. time ordered, path analytic) model that incorporates a new perspective, a historical sequence, to factors hypothesized to predict substance abuse/misuse. This project will contribute to our understanding of the role of trauma in exacerbating the predisposition to abuse and misuse of alcohol and other substances, controlling for factors such as mental health disorders and life stressors. This project will also inform policy makers who direct practice so that services can more comprehensively and holistically serve those who use/misuse substances.