This article was downloaded by: [University of Tennessee, Knoxville] On: 16 April 2015, At: 11:28 Publisher: Taylor & Francis Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK
Stress, Trauma, and Crisis: An International Journal Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/gcit20
Stress, Trauma, and Substance Use: An Overview a
Brian E. Bride & Samuel A. MacMaster a
b
University of Georgia , Athens, Georgia, USA
b
University of Tennessee , Knoxville, Tennessee, USA Published online: 25 Jan 2007.
To cite this article: Brian E. Bride & Samuel A. MacMaster (2005) Stress, Trauma, and Substance Use: An Overview, Stress, Trauma, and Crisis: An International Journal, 8:2-3, 75-78 To link to this article: http://dx.doi.org/10.1080/15434610590956868
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Stress, Trauma, and Crisis, 8:75!78, 2005 Copyright # Taylor & Francis Inc. ISSN: 1543-4613 print/1543-4591 online DOI: 10.1080/15434610590956868
Stress, Trauma, and Substance Use: An Overview BRIAN E. BRIDE Downloaded by [University of Tennessee, Knoxville] at 11:28 16 April 2015
University of Georgia, Athens, Georgia, USA
SAMUEL A. MACMASTER University of Tennessee, Knoxville, Tennessee, USA
This special issue of Stress, Trauma, and Crisis: An International Journal focuses on the interaction between stress, trauma, and substance use. In soliciting manuscripts for this special issue, we cast a deliberately wide net. It would have been relatively easy to compile eight manuscripts that addressed the topic through a myopic lens, such as by focusing only on the assessment and treatment of comorbid posttraumatic stress disorder and substance use disorders. We also could have dictated the type of interaction between the three concepts that we were interested in. For example, we could have specified that manuscripts should address the role of trauma as a risk factor for substance use disorders or the corollary, substance use as a risk factor for traumatic experiences and=or the development of PTSD. Instead, we left it up to the authors to determine how to address the issue of the interaction between stress, trauma, and substance use and where to place the emphasis. Our intention was to provide a forum for innovative manuscripts whose contribution to the literature is found in their unique approach to this interaction and application of empirical investigation to unique problems and=or populations. Matto presents a review of neuroscientific research on stress vulnerability and its effects on information processing in the context of chemical dependency. This review of basic science explicates the scientific and theoretical underpinnings of an innovative approach to the treatment of chronic chemical dependency. This new approach, the integrated sensory-linguistic model, combines visual processing activities with traditional cognitivebehavioral strategies. The broad goal of this treatment approach is to improve craving management and self-regulation capacities by controlling affective disturbance that arises during visual processing. Washington and Teague address the issue of suicide among male African-American youth. In particular, they review the literature related to the role of substance use as a risk factor for suicide among this population. In addition, spirituality is discussed as a protective factor that contributes 75
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to resiliency in African-American youth. Further, the results of a study that explores the relationship between spirituality and drug attitudes among pre-adolescent African-American males is presented, suggesting the potential for reducing unhealthy drug attitudes through the promotion of spirituality. According to Holleran and Jung, violence in the form of internalized colonialism, external oppression, and violent acts can be a primary risk factor for negative outcomes such as substance abuse among Mexican-American youth. Many of these youth also must contend with cultural tensions that arise from the acculturative process, role conflicts, school challenges, and identity formation process. However, many Mexican-American adolescents are able to navigate these stressors and traumas in a way that transforms the potentially distressing events into life-affirming rites of passage. Holleran and Jung discuss the results of a qualitative study of Mexican-American youth in a city in the southwestern United States that reveal how these youth utilize their energy, creativity, and resilience to transcend such stressors. As a life-threatening illness, the diagnosis of HIV or AIDS may be experienced as a traumatic event, while living with HIV=AIDS is experienced by some as a chronic state of stress. Further, certain traumatic experiences are associated with increased risk-behaviors for both HIV=AIDS and substance abuse, and substance use has been found to be a risk factor for certain traumatic experiences and acquiring HIV=AIDS. Jones discusses the complex interaction between chronic stress, traumatic experiences, and substance use among African American women living with HIV=AIDS, the fastest growing demographic of new HIV=AIDS cases. In addition, she presents the results of a qualitative study of African-American women with HIV=AIDS, providing insight into the interaction of the stress of a chronic illness, trauma, and substance use. Runaway=homeless youth often suffer from exposure to chronic family distress and confront numerous traumatic events in their lives. Further, they face destructive forces that impede their growth such as delinquency, risky sexual experiences, victimization, and violence. Thompson conducted a survey of runaway=homeless youth in New York and Texas to investigate levels of PTSD and the impact of substance use, family, and youth factors on symptom levels. Her results demonstrate heightened rates of trauma symptoms that are predicted by symptoms of depression, anxiety, and dissociation, as well as parental substance use. Based on these results, Thompson argues that runaway=homeless youth entering emergency shelters be evaluated for trauma and associated comorbid symptoms in a manner that recognizes developmental and contextual issues. Incarcerated women experience high rates of substance abuse disorder and high rates of physical and sexual abuse (Jordan, Schlenger, Fairbank, & Caddell, 1996; Morash, Bynum, & Koons, 1998; Teplin, Abram, & McClelland, 1996). Kubiak, Hanna, and Balton discuss the role of trauma and substance involvement in the lives of incarcerated women by exploring the institutional environment that substance-involved women may encounter during
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incarceration. In particular, Kubiak and colleagues use a narrative case study approach to describe the stories of three women who experienced sexual assault and=or harassment during their incarceration with a focus on the ways in which they coped with the abuse. Although the link between trauma and substance use disorders is well documented, assessment and treatment of trauma within substance abuse treatment programs is not often standard practice. Wiechelt and colleagues underline the importance of assessment of traumatic experiences among clients in treatment for substance abuse and report on a two phase project to identify and pilot trauma screening instruments for use in substance abuse treatment settings. The two-phase project was successful in identifying two trauma screening instruments that substance abuse treatment clinicians found to be useful in clinical settings. An additional benefit of Wiechelt and colleagues’ efforts is the demonstration of an effective and innovative research-practice collaborative effort. Comorbidity of PTSD and alcohol use disorders, depression, and physical health problems are well documented (Breslau, Davis, Peterson, & Schultz, 2000; Brown & Wolfe, 1994; Resnick, Acierno, & Kilpatrick, 1997). However, little is known about the occurrence of these problems in persons experiencing trauma symptoms that do not meet the full diagnostic criteria for PTSD. Yarvis and colleagues report on a study that examines the relationship between subthreshold PTSD and alcohol use disorders, depression, and physical health problems in Canadian peacekeepers. Their findings highlight the importance of attending to persons who have experienced traumatic events, but may not meet the full criteria for a diagnosis of PTSD. This special issue is an addition to the literature that depicts both the breadth of the relationship between stress, trauma, and substance use, as well as how closely these phenomena are linked. These eight articles provide innovative conceptual models, research findings, and recommendations to the practice field that are applied to a diverse body of individuals affected by substance abuse. As individual works they are important, when taken together under this rubric, the true nature of the multi-layered and interconnected relationship between stress and trauma, and substance abuse begins to emerge. It is the untangling of this relationship that the editors of this special issue believe holds great promise for continued research that develops a better understanding of these phenomena and ultimately improves the lives of individuals touched by trauma, crisis, and substance use.
REFERENCES Breslau, N., Davis, G. C., Peterson, E. L., and Schultz, L. R. (2000). A second look at comorbidity in victims of trauma: The posttraumatic stress disorder!major depression connection. Biological Psychiatry, 48, 902!909.
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Brown, P. J. and Wolfe, J. (1994). Substance abuse and post-traumatic stress disorder co-morbidity. Drug and Alcohol Dependency, 35, 51!59. Jordan, B. K., Schlenger, W. E., Fairbank, J. A., and Caddell, J. M. (1996). Prevalence of psychiatric disorders among incarcerated women. Archives of General Psychiatry, 53, 513!519. Morash, M., Bynum, T. S., and Koons, B. A. (1998). Women offenders: Programming needs and promising approaches. Washington, DC: U.S. Department of Justice, National Institute of Justice. Resnick, H. S., Acierno, R., and Kilpatrick, D. G. (1997). Health impact of internal personal violence 2: Medical and mental health outcomes. Behavioral Medicine, 23, 65!78. Teplin, L. A., Abram, K. M., and McClelland, G. M. (1996). The prevalence of psychiatric disorder among incarcerated women I: Pre-trial jail detainees. Archives of General Psychiatry, 53, 505!512.