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Abstract
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OBJECTIVE: Understanding the relationship between PTSD and addiction in adolescents may dramatically improve evidence-based practice in child psychiatry. We hypothesized that in a sample of substance addicted youth, PTSD would correlate with (1) female gender and racial minority status, (2) preference for anxiolytic substances, (3) higher burden of self injury and suicide attempts, and (4) earlier age of first use.
METHODS: One-hundred and ninety-five adolescents (52% female, ages 14-18) were court-referred to residential treatment and assessed at intake. Multi-informant data regarding Axis I diagnostic status and other clinical variables were collected via rater-administered, semi-structured interviews; medical chart review; and youth, parent, and clinician reports. Differences between subjects were evaluated using Fisher's exact test for binary variables or Kruskal-Wallis Chi-Square Test.
RESULTS: Substance dependent youth with comorbid PTSD were significantly more likely to be female and Latino. PTSD was correlated with preference for alcohol, narcotics, tranquilizers and inhalants. In addition, PTSD was correlated with higher burden of self-injury and suicidal behavior. Youth with PTSD were also more likely to have begun using before age 13 and reported that PTSD symptoms preceded first use.
CONCLUSIONS: Girls and Latinos may be particularly vulnerable in developing comorbid substance dependence and PTSD. Drug preferences among youth with PTSD may reflect tendencies to target symptoms such as hypervigilance and anxiety. The recognition and early intervention among youth with trauma could prevent early first use and eventual substance dependency. |