The majority of studies exploring the mental health disorders posttraumatic stress disorder and substance use disorders (substance abuse and dependence) have shown high co-morbidity rates in adolescents, indicating a well-established relationship. However, only a few studies have attempted to examine the functional mechanisms believed to underlie this common form of co-morbidity, and no studies have been carried out in adolescent samples. Knowledge is thus lacking on how specific PTSD symptom clusters may account for the development of specific types of problematic substance use in adolescents. Therefore, we studied this issue in relation to alcohol abuse (AA) and drug abuse (DA) in a probability sample of Danish 15- to 18-year-olds (n=1,988) in the form of an online survey using self-report questionnaires following the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; APA, 1994). After demographic and substance-related variables were controlled for, hierarchical multiple regression models revealed that a significant proportion of variance in AA severity was explained positively by arousal symptoms and negatively by re-experiencing symptoms, whereas DA severity was significantly increased by avoidance symptoms and decreased by arousal symptoms. Current findings suggest that specific PTSD symptom clusters to some extent are independently related to AA and DA, providing this research field with a better understanding of the interrelationship between these two mental health disorders in adolescents whilst underpinning the importance of acknowledging the specific functional mechanisms underlying the common co-occurrence of PTSD and substance abuse in adolescence.
Mental Health and Substance Use, 2014, Vol 7, Issue 4, p. 299-314