The impact of poly-traumatization on treatment outcomes in young people with substance use disorders

Sidsel Karsberg,Morten Hesse,Michael Mulbjerg Pedersen,Mads Uffe Pedersen,Ruby Charak

doi:10.1186/s12888-021-03129-x

Sidsel Karsberg, Morten Hesse + Show 3 more

Open Access

https://doi.org/10.1186/s12888-021-03129-x

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Abstract

BackgroundIt is believed that clients with psychological trauma experiences have a poor prognosis with regard to treatment participation and outcomes for substance use disorders. However, knowledge on the effect of the number of trauma experiences is scarce.MethodsUsing data from drug use disorder (DUD) treatment in Denmark, we assessed the impact of having experienced multiple potentially traumatic experiences on DUD treatment efficacy. Baseline and follow-up data from 775 young participants (mean age = 20.2 years, standard deviation = 2.6) recruited at nine treatment centers were included in analyses.ResultsAnalyses showed that participants who were exposed multiple trauma experiences also reported a significantly higher intake of cannabis at treatment entry, and a lower well-being score than participants who reported less types or no types of victimization experiences. During treatment, patients with multiple types of trauma experiences showed a slower rate of reduction of cannabis than patients with few or no trauma experiences. The number of trauma types was not associated with number of sessions attended or the development of well-being in treatment.ConclusionOverall, the results show that although traumatized youth in DUD treatment show up for treatment, helping them to reduce substance use during treatment is uniquely challenging.Trial registrationISRCTN88025085, date of registration: 29.08.2016, retrospectively registered.

Highlights

It is believed that clients with psychological trauma experiences have a poor prognosis with regard to treatment participation and outcomes for substance use disorders
Trauma experiences refers to serious adverse events that can instantaneously cause severe distress, and may lead to the syndrome known as post-traumatic stress disorder (PTSD)
In recent studies that examine the accumulative effect of trauma victimization, certain specific types of traumatic exposures, for instance, child sexual abuse have been shown to account for impairment over and above the cumulative impact of the number of specific exposure types [16,17,18]

Summary

Introduction

It is believed that clients with psychological trauma experiences have a poor prognosis with regard to treatment participation and outcomes for substance use disorders. Among the three classes that emerged, the poly-trauma group was distinct from other adversity groups in the presence of severe emotional and behavioral problems [14]. In another recent longitudinal study that included 1186 adolescents, polyvictimization was linked to lower levels of social support, self-esteem, and mastery [15]. In recent studies that examine the accumulative effect of trauma victimization, certain specific types of traumatic exposures, for instance, child sexual abuse have been shown to account for impairment over and above the cumulative impact of the number of specific exposure types [16,17,18]. None-the-less, the established links between multiple types of trauma, negative behavioral patterns, and cognitive functions may carry important implications for substance abuse treatment, in relation to treatment efficacy

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