TY - JOUR
T1 - Trauma exposure, posttraumatic stress disorder and risk for alcohol, nicotine, and marijuana dependence in Israel
AU - Walsh, Kate
AU - Elliott, Jennifer C.
AU - Shmulewitz, Dvora
AU - Aharonovich, Efrat
AU - Strous, Rael
AU - Frisch, Amos
AU - Weizman, Abraham
AU - Spivak, Baruch
AU - Grant, Bridget F.
AU - Hasin, Deborah
N1 - Funding Information:
This research was funded by National Institutes of Health grants R01AA013654, K05AA014223, T32DA031099 (Walsh, Elliott), K23DA016743 (Aharonovich), and the New York State Psychiatric Institute (Hasin). None of the authors or researchers has any connection with the tobacco, alcohol, pharmaceutical or gaming industries or anybody substantially funded by one of these organizations. We would like to acknowledge the helpful analytical advice of Melanie M. Wall, Ph.D., and consultations of Rachel Bar-Hamburger, Ph.D., Rina Meyer and Zalman Shoval in collecting the data in Israel.
PY - 2014/4
Y1 - 2014/4
N2 - Background Substance dependence is more common among trauma-exposed individuals; however, most studies suggest that Posttraumatic Stress Disorder (PTSD) accounts for the link between trauma exposure (TE) and substance dependence. Objectives This study examined associations between TE and substance dependence (alcohol, nicotine, and marijuana), and whether PTSD accounted for this association. Method 1317 Jewish Israeli household residents completed in-person structured interviews assessing TE, PTSD, and substance (alcohol, nicotine, marijuana) dependence between 2007 and 2009. Regression analyses examined associations among TE, PTSD, and substance dependence. Results In the full sample, mean number of traumatic events was 2.7 (sd = 2.2), with 83.7% experiencing at least one event. In the full sample, mean number of PTSD symptoms was 2.5 (sd = 3.4), with 13.5% meeting PTSD diagnostic criteria. Prevalence of alcohol dependence was 13.4%; nicotine dependence 52.8%; and marijuana dependence 12.1%. Number of traumatic events was associated with increased odds of alcohol (OR = 1.3; 95% CI = 1.2-1.4) and nicotine (OR = 1.2; 95% CI = 1.1-1.3) dependence. Similarly, any traumatic event exposure was associated with increased odds of alcohol (OR = 3.1; 95% CI = 1.6-6.0) and nicotine (OR = 1.9; 95% CI = 1.2-2.9) dependence. PTSD symptoms were associated with increased odds of alcohol (OR = 1.2; 95% CI = 1.1-1.3), nicotine (OR = 1.1; 95% CI = 1.1-1.2), and marijuana (OR = 1.1; 95% CI = 1.04-1.2) dependence; similarly, a PTSD diagnosis was associated with increased odds of alcohol (OR = 3.4; 95% CI = 2.1-5.5), nicotine (OR = 2.2; 95% CI = 1.4-3.4), and marijuana (OR = 2.6; 95% CI = 1.2-5.9) dependence. PTSD symptoms accounted for a sizeable proportion of the TE effect on alcohol (46%) and nicotine dependence (31%). Conclusion Individuals with more traumatic events had heightened risk for alcohol and nicotine dependence, and PTSD symptoms partially accounted for this risk. However, marijuana dependence was only significantly related to PTSD symptoms. Clinicians and researchers should separately assess different types of dependence among trauma-exposed individuals both with and without PTSD symptoms.
AB - Background Substance dependence is more common among trauma-exposed individuals; however, most studies suggest that Posttraumatic Stress Disorder (PTSD) accounts for the link between trauma exposure (TE) and substance dependence. Objectives This study examined associations between TE and substance dependence (alcohol, nicotine, and marijuana), and whether PTSD accounted for this association. Method 1317 Jewish Israeli household residents completed in-person structured interviews assessing TE, PTSD, and substance (alcohol, nicotine, marijuana) dependence between 2007 and 2009. Regression analyses examined associations among TE, PTSD, and substance dependence. Results In the full sample, mean number of traumatic events was 2.7 (sd = 2.2), with 83.7% experiencing at least one event. In the full sample, mean number of PTSD symptoms was 2.5 (sd = 3.4), with 13.5% meeting PTSD diagnostic criteria. Prevalence of alcohol dependence was 13.4%; nicotine dependence 52.8%; and marijuana dependence 12.1%. Number of traumatic events was associated with increased odds of alcohol (OR = 1.3; 95% CI = 1.2-1.4) and nicotine (OR = 1.2; 95% CI = 1.1-1.3) dependence. Similarly, any traumatic event exposure was associated with increased odds of alcohol (OR = 3.1; 95% CI = 1.6-6.0) and nicotine (OR = 1.9; 95% CI = 1.2-2.9) dependence. PTSD symptoms were associated with increased odds of alcohol (OR = 1.2; 95% CI = 1.1-1.3), nicotine (OR = 1.1; 95% CI = 1.1-1.2), and marijuana (OR = 1.1; 95% CI = 1.04-1.2) dependence; similarly, a PTSD diagnosis was associated with increased odds of alcohol (OR = 3.4; 95% CI = 2.1-5.5), nicotine (OR = 2.2; 95% CI = 1.4-3.4), and marijuana (OR = 2.6; 95% CI = 1.2-5.9) dependence. PTSD symptoms accounted for a sizeable proportion of the TE effect on alcohol (46%) and nicotine dependence (31%). Conclusion Individuals with more traumatic events had heightened risk for alcohol and nicotine dependence, and PTSD symptoms partially accounted for this risk. However, marijuana dependence was only significantly related to PTSD symptoms. Clinicians and researchers should separately assess different types of dependence among trauma-exposed individuals both with and without PTSD symptoms.
UR - http://www.scopus.com/inward/record.url?scp=84896493499&partnerID=8YFLogxK
U2 - 10.1016/j.comppsych.2013.11.016
DO - 10.1016/j.comppsych.2013.11.016
M3 - מאמר
AN - SCOPUS:84896493499
VL - 55
SP - 621
EP - 630
JO - Comprehensive Psychiatry
JF - Comprehensive Psychiatry
SN - 0010-440X
IS - 3
ER -
