Impact of Trauma on Substance Abusing Homeless Men

说明(申请人提供)：拟议的为期两年的项目建立在早先的一项探索性研究的基础上，该研究调查了患有精神疾病的无家可归者的受害情况。该项目致力于加强物质滥用的研究和实践，在控制其他已知预测因素(即精神健康障碍、生活应激源和健康状况不佳)的情况下，研究创伤与物质使用/滥用的关系。这项研究将从大约290名无家可归的人那里收集数据，关于他们在生活中经历的创伤程度，以及他们是否滥用或误用酒精或其他物质。北卡罗来纳州维克县的两家机构已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的男性人口进行广泛抽样。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设施，男性可以在那里短期戒酒。这一安排将提供一种方法来比较处于药物滥用和无家可归不同阶段的男性创伤病史的相似和/或差异。为了说明创伤对药物滥用的影响，将使用这些数据来拟合因果(即时间排序、路径分析)模型，该模型结合了新的视角、历史序列和假设的预测药物滥用/滥用的因素。这个项目将有助于我们理解创伤在加剧滥用和误用酒精和其他物质的易感性方面的作用，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政策制定者提供信息，以便服务能够更全面和全面地为那些使用/滥用物质的人提供服务。

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.