Hobkirk Andréa L, Watt Melissa H, Green Kimberly T, Beckham Jean C, Skinner Donald, Meade Christina S
Duke University, Duke Global Health Institute, 310 Trent Drive, Trent Hall, Room 329, Durham, NC, 27708, USA.
Duke University, Duke Global Health Institute, 310 Trent Drive, Trent Hall, Room 330, Durham, NC, 27708, USA.
Addict Behav. 2015 Mar;42:167-71. doi: 10.1016/j.addbeh.2014.11.030. Epub 2014 Nov 26.
South Africa has high rates of interpersonal violence and a rapidly growing methamphetamine epidemic. Previous research has linked experiences of interpersonal violence to higher rates of substance use, and identified mental health constructs as potential mediators of this association. The aim of this study was to examine the relationship between interpersonal violence and addiction severity among active methamphetamine users in Cape Town, South Africa, and to explore symptoms of posttraumatic stress disorder (PTSD) and substance use coping as mediators of this relationship. A community sample of 360 methamphetamine users was recruited through respondent driven sampling and surveyed on their experiences of violence, mental health, coping, and drug use and severity. A series of one-way ANOVAs were conducted to examine the relationship of self-reported interpersonal violence with drug addiction severity, and multiple mediation analyses were used to determine if PTSD symptoms and substance use coping mediated this relationship. The majority (87%) of the sample reported experiencing at least one instance of interpersonal violence in their lifetime, and the number of violent experiences was associated with increased drug addiction severity. PTSD and substance use coping were significant mediators of this association. Only the indirect effect of substance use coping remained significant for the female sample when the mediation model was conducted separately for men and women. The findings point to the need for integrated treatments that address drug use and PTSD for methamphetamine users in South Africa and highlight the importance of coping interventions for women.
南非人际暴力发生率很高，甲基苯丙胺流行情况也在迅速加剧。先前的研究已将人际暴力经历与更高的物质使用发生率联系起来，并确定心理健康因素是这种关联的潜在调节因素。本研究的目的是调查南非开普敦甲基苯丙胺现用者人际暴力与成瘾严重程度之间的关系，并探讨创伤后应激障碍（PTSD）症状和物质使用应对方式作为这种关系的调节因素。通过应答者驱动抽样招募了360名甲基苯丙胺使用者的社区样本，并对他们的暴力经历、心理健康、应对方式以及药物使用和严重程度进行了调查。进行了一系列单因素方差分析以检验自我报告的人际暴力与药物成瘾严重程度之间的关系，并使用多重中介分析来确定PTSD症状和物质使用应对方式是否介导了这种关系。样本中的大多数（87%）报告称在其一生中至少经历过一次人际暴力事件，暴力经历的次数与药物成瘾严重程度增加有关。PTSD和物质使用应对方式是这种关联的重要调节因素。当分别对男性和女性进行中介模型分析时，只有物质使用应对方式的间接效应在女性样本中仍然显著。研究结果表明，南非需要针对甲基苯丙胺使用者开展综合治疗，解决药物使用和PTSD问题，并强调应对干预对女性的重要性。
