Physical and Sexual Abuse Among Women and Men with Substance Use Disorders

Abstract

This study focuses on the association of physical and sexual abuse with psychological symptoms and associated functioning among substance use disorder (SUD) patients and whether patient gender moderates these associations. A total of 24,959 treatment seeking patients who had SUDs were assessed with the Addiction Severity Index (ASI) as part of a Department of Veterans Affairs (VA) initiative to evaluate the quality of VA mental health treatment. A high proportion of SUD patients had trauma histories and women experienced more sexual victimization and more dual abuse (both physical and sexual abuse) than men. Abuse history was associated with more problems across ASI domains, which include alcohol, drug, psychiatric, medical, social/family, legal, and employment problems. In addition, abuse was related to receiving comorbid psychiatric diagnoses, including affective, anxiety, and psychotic disorders, and posttraumatic stress disorder. Patient gender emerged as a moderator of several of these associations. Clinicians who work with female and male patients with SUDs and comorbid histories of interpersonal trauma should be aware of the distinct clinical presentation and consequent treatment needs.