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APHA Scientific Session and Event Listing

Philip L. Reed, PhD, MSc, James C. Anthony, PhD, and Naomi Breslau, PhD. Department of Epidemiology, Michigan State University, B601 West Fee Hall, East Lansing, MI 48824, 517-353-9445, reedph@ht.msu.edu

This prospective study estimated the association between a past history of trauma and posttraumatic stress disorder (PTSD) and risk for incident clinical features of alcohol and other drug dependence in an epidemiological sample. Data are from two young adult assessments of 2,311 children enrolled in a longitudinal study at entry to first grade of primary school in 1985-86. Of 1,692 participants completing the first young adult assessment in 2000-2002, 1,352 were free of drug and alcohol dependence symptoms and, therefore, were at risk for onset of dependence. The adjusted incidence rate ratios (aIRR) for drug and alcohol dependence, as observed at the second young adult assessment (one year later), were estimated using negative binomial regression. Included in the regression equations were covariates for demographic characteristics, individual drugs used, childhood predispositional traits assessed in earlier study waves, smoking, and socioeconomic status (measured at three times). RESULTS: Compared to persons with no trauma exposure, persons exposed to trauma with associated PTSD had an elevated risk for newly incident clinical features (CF) of (non-alcohol) drug dependence (aIRR=8.5, 95% Confidence Interval, CI: 2.4, 29.9), and also an elevated risk for CF of alcohol dependence (aIRR=10.1, 95% CI: 3.2, 32.0). Exposure to trauma alone (without PTSD) signaled an increased risk for CF of drug dependence (aIRR = 3.2, 95% CI: 1.1, 9.2), but no significant risk for alcohol dependence. The risk estimates for both alcohol and non-alcohol drug dependence were significantly higher for trauma victims with PTSD than for persons with trauma exposure alone (p-values<0.02).

Learning Objectives: At the conclusion of the session, participant in this session will be able to

• Define the difference between trauma exposure and trauma with PTSD.
• Articulate the different levels of risk for substance dependence associated with exposure to trauma and exposure to trauma with PTSD.
• Apply the authors methodology for analyzing the differences in risk associated with comorbid disorders such as PTSD and substance dependence.
• Be better equipped to prioritize treatment and prevention programs aimed at comorbid PTSD and substance use disorders.

Keywords: Psychiatric Epidemiology, Drug Abuse

Presenting author's disclosure statement:

Any relevant financial relationships? No