1. Substance use to regulate intense posttraumatic shame in individuals with childhood abuse and neglect
- Author
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Sebastian Wolff, Elisabeth A. Arens, Julia Holl, Malte Stopsack, Maren Schumacher, Michael Klein, Anja Höcker, Jonna Südhof, Philipp Hiller, Sven Barnow, Gabriela Spindler, and Ingo Schäfer
- Subjects
Adult ,Male ,050103 clinical psychology ,medicine.medical_specialty ,Substance-Related Disorders ,media_common.quotation_subject ,Ecological Momentary Assessment ,Emotions ,Poison control ,Shame ,Suicide prevention ,Neglect ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Risk Factors ,Injury prevention ,Developmental and Educational Psychology ,medicine ,Humans ,0501 psychology and cognitive sciences ,Psychiatry ,media_common ,Adult Survivors of Child Abuse ,05 social sciences ,food and beverages ,Human factors and ergonomics ,Middle Aged ,medicine.disease ,030227 psychiatry ,Sadness ,Substance abuse ,Psychiatry and Mental health ,Female ,Psychology ,Clinical psychology - Abstract
Childhood abuse and neglect (CAN) is considered as a risk factor for substance use disorder (SUD). Based on the drinking to cope model, this study investigated the association of two trauma-relevant emotions (shame and sadness) and substance use. Using ecological momentary assessment we compared real-time emotion regulation in situations with high and low intensity of shame and sadness in currently abstinent patients with CAN and lifetime SUD (traumaSUD group), healthy controls with CAN (traumaHC group), and without CAN (nontraumaHC group). Multilevel analysis showed a positive linear relationship between high intensity of both emotions and substance use for all groups. The traumaSUD group showed heightened substance use in low, as well as in high, intensity of shame and sadness. In addition, we found an interaction between type of emotion, intensity, and group: the traumaHC group exhibited a fourfold increased risk for substance use in high intense shame situations relative to the traumaSUD group. Our findings provide evidence for the drinking to cope model. The traumaSUD group showed a reduced distress tolerance for variable intensity of negative emotions. The differential effect of intense shame for the traumaHC group emphazises its potential role in the development of SUD following CAN. In addition, shame can be considered a relevant focus for therapeutic preinterventions and interventions for SUD after CAN.
- Published
- 2016