Abstract
ObjectivesAdolescents with substance use disorders (SUD) frequently report traumatic events (TEs) and symptoms of post-traumatic stress disorder (PTSD). This study aimed to assess whether lifetime prevalence rates of TEs and PTSD are related to SUD severity in adolescent psychiatric patients.MethodsWe analyzed N = 114 self-reports of treatment-seeking German adolescents aged 12 to 18 years, who visited a specialized SUD outpatient unit. Standardized questionnaires were applied to assess SUD severity, the number of TEs and DSM-IV PTSD criteria.ResultsPatients fulfilling PTSD criteria (28% of the total sample) had a higher Drug Use Disorders Identification Test (DUDIT) score compared to non-PTSD patients with TEs (p <.001), and compared to adolescents without TEs or PTSD (p = .003). Additionally, SUD severity was positively associated with the number of TEs and the number of intrusion, hyperarousal, and avoidance symptoms (all r = .33 to.48, all p <.01).DiscussionAdolescent patients with SUD reported 3-times higher rates of TEs, and a 5-time higher prevalence of PTSD following TEs, than the general adolescent population. Adolescent SUD patients with PTSD reported more severe substance use problems than patients without PTSD—regardless of previous TEs. Longitudinal studies are needed in order to investigate the temporal relationship between TEs, PTSD and SUD.
Highlights
Adolescence, as defined by the World Health Organization, is a phase of life between ages 10 and 19 that marks the transition from childhood to adulthood (1, 2)
Patients fulfilling post-traumatic stress disorder (PTSD) criteria (28% of the total sample) had a higher Drug Use Disorders Identification Test (DUDIT) score compared to non-PTSD patients with traumatic events (TEs) (p
We investigated differences in substance use disorder (SUD) severity between three groups (PTSD, TE, NoTE) of treatment-seeking adolescents at a German outpatient clinic for adolescent substance abuse
Summary
Adolescence, as defined by the World Health Organization, is a phase of life between ages 10 and 19 that marks the transition from childhood to adulthood (1, 2). Adolescents are “biologically wired” (3) to engage in risky and potentially harmful behavior including the use of psychoactive substances, which might lead to the development of a substance use disorder (SUD) (4). The increase in risk behavior might lead to identification with substance-related subcultures In Germany, the lifetime prevalence rate of SUD in adolescents and young adults is 28.6% (6), with SUD being associated with worse performance in school, worse overall health, higher mortality rates and increased rates of comorbid psychiatric disorders such as post-traumatic stress disorder (PTSD) (7–9). PTSD is an anxiety disorder that may develop subsequent to exposure to traumatic events (TEs), either experienced or witnessed. TEs are defined as experiences that involve actual or threatened
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