Search

Objective: Child abuse is a risk factor for developing Posttraumatic Stress Disorder (PTSD) and subsequent Substance Use Disorder (SUD). The purpose of this review is to summarize current knowledge about effective treatments for adolescent abuse-related PTSD, SUD, and the co-occurrence of these conditions. Method: The literature on empirical treatment studies for these conditions in adolescence was reviewed, summarized, and synthesized. Results: Randomized controlled studies of abuse-related PTSD and SUD in adolescents have supported the efficacy of cognitive behaviorally-based individual and family treatment components. Components overlap considerably in empirically supported treatments for each disorder. An integrated treatment approach is described for use in adolescents with abuse-related PTSD and SUD, with recommendations for optimizing services for this population and for future research. Conclusions: The available evidence on effective treatments suggests that integrated PTSD- and SUD-focused cognitive-behavioral and family treatment for adolescents with comorbid abuse-related PTSD and SUD may optimize outcomes for this population. Keywords: Posttraumatic stress disorder; Substance use disorder; Child abuse; Adolescents; Integrated treatment

Objective: This study was conducted to examine the relationship between substance use patterns among adolescents and their histories of physical and/or sexual abuse. Method: The Minnesota Student Survey was administered in 1995 to 122,824 public school students in Grades 6, 9, and 12. Substance user groups were created based on frequency of use and the number of substances used. Use of individual substances, use of multiple substances, age of first use, and reasons for use were examined with respect to histories of physical and/or sexual abuse. Results: Physical and sexual abuse were associated with an increased likelihood of the use of alcohol, marijuana, and almost all other drugs for both males and females in the three grades surveyed. Use of multiple substances was highly elevated among victims of abuse, with the highest rates seen among students who reported both physical and sexual abuse. Abuse victims also reported initiating substance use earlier than their nonabused peers and gave more reasons for using, including use to cope with painful emotions and to escape from problems. Conclusion: Because of their increased vulnerability, young victims of physical and sexual abuse need improved prevention, early intervention, and treatment services related to substance use. Key Words - Alcohol/drug abuse, Multiple drug use, Adolescents, Physical abuse, Sexual abuse.

Objectives. Using two existing ethnographic studies of drug-involved adults, this study evaluates the association between child-abuse victimization and levels of involvement inhalant use. Methods. Historical accounts of childhood exposure to physical or sexual abuse were compared among nonusers of inhalants (n = 197), light inhalant users (n = 64), and heavy inhalant users (n = 24). Crude and adjusted odds ratios were used to compare informants with no history of inhalant use with those having a history of light inhalant use and those having a history of heavy inhalant use. Results. Heavy inhalant use was associated with history of any child abuse (adjusted odds ratio [OR) = 4.6) and physical abuse (adjusted OR = 3.8). Light inhalant use showed no association with child-abuse history. Conclusions. Child abuse may be an important correlate of extensive involvement in inhalant use. The findings invite speculation with respect to a hypothetical causal role for child abuse in the etiology of inhalant use. The lack of support for causality in this study underscores the need for replication and more carefully designed longitudinal research. (Am J Public Health. 1997;87;765-769)