Johnson Sharon D, Striley Catherine, Cottler Linda B
University of Missouri-St. Louis, School of Social Work, 590 Lucas Hall, One University Blvd. St. Louis, MO 63121, United States.
Addict Behav. 2006 Nov;31(11):2063-73. doi: 10.1016/j.addbeh.2006.02.007. Epub 2006 Mar 31.
This study examines the association of traumatic exposure, PTSD and substance use among 1098 out-of-treatment African American drug users. Over 40% of the respondents experienced a DSM-III-R qualifying traumatic event with 44% of those developing PTSD. Early onsets of marijuana and heroin use, alcohol dependence and opiate dependence were each associated with exposure to a traumatic event for males and early onset alcohol use and alcohol dependence were associated with females' exposure to a traumatic event. Alcohol dependence and depression disorder were co morbid with PTSD in men, while the early onset of alcohol and alcohol dependence were associated with PTSD in women. In the 16% of the sample who reported trauma exposure and poly-substance use, the trauma occurred after the onset of all substance use, with the exception of crack cocaine use. Implications for multifaceted treatment which addresses multiple psychopathologies, PTSD, and risk for exposure are discussed.
本研究调查了1098名未接受治疗的非裔美国吸毒者中创伤暴露、创伤后应激障碍（PTSD）与物质使用之间的关联。超过40%的受访者经历了符合《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）标准的创伤事件，其中44%的人患上了创伤后应激障碍。男性使用大麻和海洛因的早期发作、酒精依赖和阿片类药物依赖均与创伤事件暴露有关，而女性使用酒精的早期发作和酒精依赖与创伤事件暴露有关。男性中酒精依赖和抑郁症与创伤后应激障碍共病，而女性中酒精使用和酒精依赖的早期发作与创伤后应激障碍有关。在报告有创伤暴露和多种物质使用的16%的样本中，除快克可卡因使用外，创伤发生在所有物质使用开始之后。本文还讨论了针对多种精神病理学、创伤后应激障碍和暴露风险进行多方面治疗的意义。
