Stability of trauma-related symptoms during acute substance use treatment

ABSTRACT

It is unclear whether post-traumatic stress disorder symptoms and reports of traumatic childhood experiences decline during substance withdrawal. A convenience sample of 34 inpatients of the Psychiatric University Clinics in Basel was recruited and general psychopathological and trauma-related symptoms were assessed with the Brief Symptom Checklist, Post-Traumatic Stress Diagnostic Scale, and Childhood Trauma Questionnaire in the 1st and 3rd week of substance use treatment. The average age of the sample was 41.9 (SD = 9.1) years, and 26.5% were female. Hyperarousal (M_t1 = 4.51 versus M_t2 = 3.61; z = –2.38, p = .017) and avoidance symptoms (M_t1 = 6.24 versus M_t2 = 4.27; z = –2.59, p = .010) declined significantly, but re-experiencing symptoms (M_t1 = 4.00 versus M_t2 = 3.45; z = –.50, p = .617) did not. Post-traumatic stress disorder assessment, according to the Diagnostic and Statistical Manual of Mental Disorders–4th edition criteria, remained constant for 28 of 34 patients. Likewise, self-reported childhood trauma experiences decreased, yet the number of elevated subscale scores remained stable. Post-traumatic stress disorder symptoms are not adequately treated by substance withdrawal alone. Trauma-specific diagnostics can be initiated with sufficient quality as early as the first week of withdrawal treatment.

KEYWORDS:

• Trauma
• alcohol
• addiction
• PTSD
• psychopathology
• withdrawal

Acknowledgments

The authors would like to thank Maggie Schauer and Thomas Elbert for their advice in designing the study. Julia Meyin Chan and Katja Klostermann are appreciated for their support in data collection. Most of all, the authors are grateful to the participants, without whom the study would not have been possible.