What is the relationship between post-traumatic stress disorder and addiction?

Post-Traumatic Stress Disorder

The lifetime prevalence rate for exposure to a potentially traumatic event is approximately 70 percent, while the lifetime prevalence rate for post-traumatic stress disorder (PTSD) is approximately 8 to 12 percent. These statistics mean that not all people exposed to potentially traumatic events will develop subsequent PTSD.

A number of factors may mediate the relationship between the occurrence of a traumatic stressor and the development of PTSD symptoms, including the nature of the traumatic event, demographic characteristics of the person (for example, his or her age and gender), and the person’s coping resources. For example, research indicates that women are twice as likely as men to develop PTSD. This statistic likely means that women are more likely than men to experience personally violent traumatic events (such as sexual assault). Research indicates that when men experience trauma such as sexual assault, their rates of PTSD can be as high as among women.

Events qualifying as potentially traumatic include surviving a natural disaster, being involved in or witnessing a motor vehicle accident, being the victim of a physical or sexual assault, childhood emotional or physical abuse, being kidnapped or abducted, and being exposed to combat or a war zone. While this list is not exhaustive, it captures the overall quality of extreme traumatic stressors. Additional qualifications include the criteria that the traumatic event was personal or direct and that the person’s response to the event included intense fear, helplessness, or horror.

There are four diagnostic behavioral symptoms used by clinicians to diagnose PTSD in individuals. "Re-experiencing" involves nightmares or disturbing day-time spontaneous memories of the traumatic event, flashbacks, or prolonged psychological distress. "Avoidance" is used to describe disturbing memories the individual may experience or any upsetting, intrusive, or debilitating thoughts, feelings, reminders of the event. "Negative cognition and mood" relates to any of the multitude of emotions that may accompanying the after-effects of the event, such as a persistent sense of blame of oneself or others for the trauma, detachment or estrangement from others or a noticeable disinterest in previously enjoyable activities, and an inability to remember specific details of the event. "Arousal" is used to explain noticeable aggression or reckless or self-destructive behavior or sleep disturbances, which professional refer to as the "fight" portion of the "fight or flight" theory.

Dual Diagnosis

An estimated 30 to 50 percent of people seeking treatment for substance-related problems also suffer from PTSD; the rate is much higher among women. One way a person might cope with the symptoms of PTSD is by abusing substances to self-medicate (that is, to decrease the presence or effect of unpleasant symptoms) or to punish oneself because of feelings of guilt, self-blame, and shame associated with the traumatic event.

A person might self-medicate to escape from and attempt to forget the pain of post-traumatic symptoms and to enter into a state of oblivion. These coping responses, however, are generally unhelpful and counterproductive from the perspective of therapeutic recovery.

Alternatively, another mechanism of action between PTSD and substance abuse is the possibility that underlying substance-related problems may place a person at greater risk for developing PTSD. According to this model, recurrent substance abuse may increase the likelihood that a person is exposed to potentially traumatic situations and, therefore, to PTSD, as substance abuse reduces judgment and decision-making capabilities and increases risky behavior. It is likely that both of these models (that is, PTSD as a precursor to substance-related problems and substance-related problems as a precursor to PTSD) help to explain the relationship between PTSD and addiction.

Bibliography

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Khantzian, Edward J. "Addiction as a Self‐regulation Disorder and the Role of Self‐medication." Addiction 108.4 (2013): 668–69. Print.

Messman-Moore, Terri L., Rose Marie Ward, and Amy L. Brown. “Substance Use and PTSD Symptoms Impact the Likelihood of Rape and Revictimization in College Women.” Journal of Interpersonal Violence 24.3 (2009): 499–521. Print.

Najavits, Lisa M. “Helping ‘Difficult’ Patients.” Psychotherapy Research 11.2 (2001): 131–52. Print.

"Post Traumatic Stress Disorder and Addiction." Dual Diagnosis. Dual Diagnosis, 2015. Web. 4 Nov. 2015.

Tipps, Megan E., Jonathan D. Raybuck, and K. Matthew Lattal. "Substance Abuse, Memory, and Post-traumatic Stress Disorder." Neurobiology of Learning and Memory 112 (2014): 87–100. Print.