The associations between traumatic experiences and subsequent onset of a substance use disorder: Findings from the World Health Organization World Mental Health surveys.
Journal: Drug and alcohol dependence
Volume: 240
Issue:
Year of Publication: 2022
Affiliated Institutions:
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia. Electronic address: l.degenhardt@unsw.edu.au.
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
Department of Epidemiology, Services, and Prevention Research (DESPR), National Institute on Drug Abuse (NIDA), National Institute of Health (NIH), Bethesda, MD, USA.
Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY, USA.
Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain; Pompeu Fabra University (UPF), Barcelona, Spain.
Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium.
School of Psychology, Ulster University, Londonderry, United Kingdom.
IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
Department of Developmental Psychology, University of Groningen, Groningen, the Netherlands; Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, Groningen, the Netherlands.
National School of Public Health, Management and Development, Bucharest, Romania.
Department of Psychiatry, University College Hospital, Ibadan, Nigeria.
Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain.
School of Public Health, The University of Queensland, Herston, Queensland, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Queensland, Australia.
National Center of Public Health and Analyses, Sofia, Bulgaria.
Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon; Balamand University, Faculty of Medicine, Beirut, Lebanon.
Ecole des Hautes Etudes en Santé Publique (EHESP), EA , Paris Descartes University, Paris, France.
Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong.
Department of Psychiatry, College of Medicine, University of Ibadan; University College Hospital, Ibadan, Nigeria.
National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico.
Unidad de Docencia, Investigacion y Formación en Salud Mental, Servicio Murciano de Salud, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca, Spain; Centro de Investigación Biomédica en ERed en Epidemíologia y Salud Pública, Murcia, Spain.
Instituto Nacional de Salud, Universidad Cayetano Heredia, Lima, Peru.
Colegio Mayor de Cundinamarca University, Faculty of Social Sciences, Bogota, Colombia.
Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand.
Dept of Psychiatry & Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, Republic of South Africa.
National Institute of Mental Health, National Center for Neurology and Psychiatry, Kodaira, Tokyo, Japan.
Department of Mathematics, Statistics and Computer Science, Dordt College, Sioux Center, IA, USA.
Center for Excellence on Research in Mental Health, CES University, Medellin, Colombia.
Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitoria, Brazil.
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
Abstract summary
Exposure to traumatic events (TEs) is associated with substance use disorders (SUDs). However, most studies focus on a single TE, and are limited to single countries, rather than across countries with variation in economic, social and cultural characteristics. We used cross-national data to examine associations of diverse TEs with SUD onset, and variation in associations over time.Data come from World Mental Health surveys across 22 countries. Adults (n = 65,165) retrospectively reported exposure to 29 TEs in six categories: "exposure to organised violence"; "participation in organised violence"; "interpersonal violence"; "sexual-relationship violence"; "other life-threatening events"; and those involving loved ones ("network traumas"). Discrete-time survival analyses were used to examine associations with subsequent first SUD onset.Most (71.0%) reported experiencing at least one TE, with network traumas (38.8%) most common and exposure to organised violence (9.5%) least. One in five (20.3%) had been exposed to sexual-relationship violence and 26.6% to interpersonal violence. Among the TE exposed, lifetime SUD prevalence was 14.5% compared to 5.1% with no trauma exposure. Most TE categories (except organised violence) were associated with increased odds of SUD. Increased odds of SUD were also found following interpersonal violence exposure across all age ranges (ORs from 1.56 to 1.78), and sexual-relationship violence exposure during adulthood (ORs from 1.33 to 1.44), with associations persisting even after >11 years.Sexual and interpersonal violence have the most consistent associations with progression to SUD; increased risk remains for many years post-exposure. These need to be considered when working with people exposed to such traumas.
Authors & Co-authors:
Degenhardt Louisa L
Bharat Chrianna C
Glantz Meyer D MD
Bromet Evelyn J EJ
Alonso Jordi J
Bruffaerts Ronny R
Bunting Brendan B
de Girolamo Giovanni G
de Jonge Peter P
Florescu Silvia S
Gureje Oye O
Haro Josep Maria JM
Harris Meredith G MG
Hinkov Hristo H
Karam Elie G EG
Karam Georges G
Kovess-Masfety Viviane V
Lee Sing S
Makanjuola Victor V
Medina-Mora Maria Elena ME
Navarro-Mateu Fernando F
Piazza Marina M
Posada-Villa José J
Scott Kate M KM
Stein Dan J DJ
Tachimori Hisateru H
Tintle Nathan N
Torres Yolanda Y
Viana Maria Carmen MC
Kessler Ronald C RC
Study Outcome
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