Drinking to ease the burden: a cross-sectional study on trauma, alcohol abuse and psychopathology in a post-conflict context
Ertl V, Saile R, Neuner F, Catani C (2016)
BMC Psychiatry 16(1): 202.
Zeitschriftenaufsatz
| Veröffentlicht | Englisch
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Abstract / Bemerkung
Background
It is likely that alcohol use and abuse increase during and after violent conflicts. The most prominent explanation of this phenomenon has been referred to as self-medication hypothesis. It predicts that psychotropic substances are consumed to deal with conflict-related psychic strains and trauma. In northern Uganda, a region that has been affected by a devastating civil war and is characterized by high levels of alcohol abuse we examined the associations between war-trauma, childhood maltreatment and problems related to alcohol use. Deducing from the self-medication hypothesis we assumed alcohol consumption moderates the relationship between trauma-exposure and psychopathology.
Methods
A cross-sectional epidemiological survey targeting war-affected families in post-conflict northern Uganda included data of male (n = 304) and female (n = 365) guardians. We used standardized questionnaires in an interview format to collect data on the guardians’ socio-demography, trauma-exposure, alcohol consumption and symptoms of alcohol abuse, PTSD and depression.
Results
Symptoms of current alcohol use disorders were present in 46 % of the male and 1 % of the female respondents. A multiple regression model revealed the unique contributions of emotional abuse in the families of origin and trauma experienced outside the family-context in the prediction of men’s alcohol-related symptoms. We found that alcohol consumption moderated the dose-effect relationship between trauma-exposure and symptoms of depression and PTSD. Significant interactions indicated that men who reported more alcohol-related problems experienced less increase in symptoms of PTSD and depression with increasing trauma-exposure.
Conclusions
The gradual attenuation of the dose-effect the more alcohol-related problems were reported is consistent with the self-medication hypothesis. Hence, the functionality of alcohol consumption has to be considered when designing and implementing addiction treatment in post-conflict contexts.
Stichworte
Trauma Addiction Alcohol Substance abuse Self-medication Depression PTSD Mental health Conflict War
Erscheinungsjahr
2016
Zeitschriftentitel
BMC Psychiatry
Band
16
Ausgabe
1
Art.-Nr.
202
ISSN
1471-244X
Finanzierungs-Informationen
Open-Access-Publikationskosten wurden durch die Deutsche Forschungsgemeinschaft und die Universität Bielefeld gefördert.
Page URI
https://pub.uni-bielefeld.de/record/2904502
Zitieren
Ertl V, Saile R, Neuner F, Catani C. Drinking to ease the burden: a cross-sectional study on trauma, alcohol abuse and psychopathology in a post-conflict context. BMC Psychiatry. 2016;16(1): 202.
Ertl, V., Saile, R., Neuner, F., & Catani, C. (2016). Drinking to ease the burden: a cross-sectional study on trauma, alcohol abuse and psychopathology in a post-conflict context. BMC Psychiatry, 16(1), 202. doi:10.1186/s12888-016-0905-7
Ertl, Verena, Saile, Regina, Neuner, Frank, and Catani, Claudia. 2016. “Drinking to ease the burden: a cross-sectional study on trauma, alcohol abuse and psychopathology in a post-conflict context”. BMC Psychiatry 16 (1): 202.
Ertl, V., Saile, R., Neuner, F., and Catani, C. (2016). Drinking to ease the burden: a cross-sectional study on trauma, alcohol abuse and psychopathology in a post-conflict context. BMC Psychiatry 16:202.
Ertl, V., et al., 2016. Drinking to ease the burden: a cross-sectional study on trauma, alcohol abuse and psychopathology in a post-conflict context. BMC Psychiatry, 16(1): 202.
V. Ertl, et al., “Drinking to ease the burden: a cross-sectional study on trauma, alcohol abuse and psychopathology in a post-conflict context”, BMC Psychiatry, vol. 16, 2016, : 202.
Ertl, V., Saile, R., Neuner, F., Catani, C.: Drinking to ease the burden: a cross-sectional study on trauma, alcohol abuse and psychopathology in a post-conflict context. BMC Psychiatry. 16, : 202 (2016).
Ertl, Verena, Saile, Regina, Neuner, Frank, and Catani, Claudia. “Drinking to ease the burden: a cross-sectional study on trauma, alcohol abuse and psychopathology in a post-conflict context”. BMC Psychiatry 16.1 (2016): 202.
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Carr CP, Martins CM, Stingel AM, Lemgruber VB, Juruena MF., J. Nerv. Ment. Dis. 201(12), 2013
PMID: 24284634
Carr CP, Martins CM, Stingel AM, Lemgruber VB, Juruena MF., J. Nerv. Ment. Dis. 201(12), 2013
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Vaughn MG, Salas-Wright CP, Huang J, Qian Z., 2015
Burden attributable to child maltreatment in Australia.
Moore SE, Scott JG, Ferrari AJ, Mills R, Dunne MP, Erskine HE, Devries KM, Degenhardt L, Vos T, Whiteford HA, McCarthy M, Norman RE., Child Abuse Negl 48(), 2015
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Moore SE, Scott JG, Ferrari AJ, Mills R, Dunne MP, Erskine HE, Devries KM, Degenhardt L, Vos T, Whiteford HA, McCarthy M, Norman RE., Child Abuse Negl 48(), 2015
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Childhood maltreatment predicts allostatic load in adulthood.
Widom CS, Horan J, Brzustowicz L., Child Abuse Negl 47(), 2015
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Widom CS, Horan J, Brzustowicz L., Child Abuse Negl 47(), 2015
PMID: 25700779
AUTHOR UNKNOWN, 0
The rates and correlates of the exposure of Palestinian adolescents to family violence: toward an integrative-holistic approach.
Haj-Yahia MM, Abdo-Kaloti R., Child Abuse Negl 27(7), 2003
PMID: 14627079
Haj-Yahia MM, Abdo-Kaloti R., Child Abuse Negl 27(7), 2003
PMID: 14627079
Predictors of violence against children in Tamil families in northern Sri Lanka.
Sriskandarajah V, Neuner F, Catani C., Soc Sci Med 146(), 2015
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Sriskandarajah V, Neuner F, Catani C., Soc Sci Med 146(), 2015
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Two-year posttreatment functioning and coping of substance abuse patients with posttraumatic stress disorder
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Substance use disorder and posttraumatic stress disorder comorbidity: addiction and psychiatric treatment rates
Brown PJ, Stout RL, Mueller T., 1999
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Trauma and PTSD in patients with alcohol, drug, or dual dependence: a multi-center study.
Driessen M, Schulte S, Luedecke C, Schaefer I, Sutmann F, Ohlmeier M, Kemper U, Koesters G, Chodzinski C, Schneider U, Broese T, Dette C, Havemann-Reinecke U; TRAUMAB-Study Group., Alcohol. Clin. Exp. Res. 32(3), 2008
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Driessen M, Schulte S, Luedecke C, Schaefer I, Sutmann F, Ohlmeier M, Kemper U, Koesters G, Chodzinski C, Schneider U, Broese T, Dette C, Havemann-Reinecke U; TRAUMAB-Study Group., Alcohol. Clin. Exp. Res. 32(3), 2008
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Childhood abuse as a factor in attrition from drug rehabilitation.
Palmer JA, Palmer LK, Williamson D., Psychol Rep 76(3 Pt 1), 1995
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Palmer JA, Palmer LK, Williamson D., Psychol Rep 76(3 Pt 1), 1995
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Dropout among patients in qualified alcohol detoxification treatment: the effect of treatment motivation is moderated by Trauma Load.
Odenwald M, Semrau P., Subst Abuse Treat Prev Policy 8(), 2013
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Odenwald M, Semrau P., Subst Abuse Treat Prev Policy 8(), 2013
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Comorbidity of posttraumatic stress disorder and alcohol dependence in displaced persons.
Kozaric-Kovacic D, Ljubin T, Grappe M., Croat. Med. J. 41(2), 2000
PMID: 10853047
Kozaric-Kovacic D, Ljubin T, Grappe M., Croat. Med. J. 41(2), 2000
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Combat-related posttraumatic stress disorder and severity of substance abuse in Vietnam veterans.
McFall ME, Mackay PW, Donovan DM., J. Stud. Alcohol 53(4), 1992
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Understanding comorbidity between PTSD and substance use disorders: two preliminary investigations.
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Saladin ME, Brady KT, Dansky BS, Kilpatrick DG., Addict Behav 20(5), 1995
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Ertl V, Preusse M, Saile R, Neuner F, Catani C., 2015
Psychosocial models of functional associations between posttraumatic stress disorder and substance use disorder
Stewart SH, Conrod PJ., 2003
Stewart SH, Conrod PJ., 2003
AUTHOR UNKNOWN, 0
Life stress, physiological and subjective indexes of negative emotionality, and coping reasons for drinking: is there evidence for a self-medication model of alcohol use?
Colder CR., Psychol Addict Behav 15(3), 2001
PMID: 11563801
Colder CR., Psychol Addict Behav 15(3), 2001
PMID: 11563801
Biomarker testing to estimate under-reported heavy alcohol consumption by persons with HIV initiating ART in Uganda.
Hahn JA, Bwana MB, Javors MA, Martin JN, Emenyonu NI, Bangsberg DR., AIDS Behav 14(6), 2010
PMID: 20697796
Hahn JA, Bwana MB, Javors MA, Martin JN, Emenyonu NI, Bangsberg DR., AIDS Behav 14(6), 2010
PMID: 20697796
Exposure to war crimes and implications for peace building in northern Uganda.
Vinck P, Pham PN, Stover E, Weinstein HM., JAMA 298(5), 2007
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Vinck P, Pham PN, Stover E, Weinstein HM., JAMA 298(5), 2007
PMID: 17666675
Prevalence of and factors associated with male perpetration of intimate partner violence: findings from the UN Multi-country Cross-sectional Study on Men and Violence in Asia and the Pacific.
Fulu E, Jewkes R, Roselli T, Garcia-Moreno C; UN Multi-country Cross-sectional Study on Men and Violence research team, Fulu E, Jewkes R, Warner X, Miedema S, Roselli T, Lang J, Naved RT, Huque H, Farah S, Shuvra MM, Erken A, Xiangxian W, Gang F, Hongtao L, Mudrovcic Z, Hua W, Hoekman A, Nikulainen E, Coquelin B, Khan M, Kusuma W, Manero CM, Larsen F, Fulu E, Warner X, Moussavi S, de Mel N, Peiris P, Gomez S, Jinadasa K, Nurhayati E, Saeroni SA, Kodriati N, Annisa R, Hakimi M, Susilastuti DH, Faiz D, Dixon A, Williams E, Jewkes R, Sikweyiya Y, Shai N, Drapuluvik-Tinabar F, Flore C, Magoola P, Agyenta A, Shanahan T, Vienings T, Jewkes R, Garcia-Moreno C, Naved RT, Jinadasa K, Vienings T, Kusuma W, Jewkes R, Connell R, Barker G, Greig A, Roy R, Verma R, Sen KM, Flood M, Johnson S., Lancet Glob Health 1(4), 2013
PMID: 25104345
Fulu E, Jewkes R, Roselli T, Garcia-Moreno C; UN Multi-country Cross-sectional Study on Men and Violence research team, Fulu E, Jewkes R, Warner X, Miedema S, Roselli T, Lang J, Naved RT, Huque H, Farah S, Shuvra MM, Erken A, Xiangxian W, Gang F, Hongtao L, Mudrovcic Z, Hua W, Hoekman A, Nikulainen E, Coquelin B, Khan M, Kusuma W, Manero CM, Larsen F, Fulu E, Warner X, Moussavi S, de Mel N, Peiris P, Gomez S, Jinadasa K, Nurhayati E, Saeroni SA, Kodriati N, Annisa R, Hakimi M, Susilastuti DH, Faiz D, Dixon A, Williams E, Jewkes R, Sikweyiya Y, Shai N, Drapuluvik-Tinabar F, Flore C, Magoola P, Agyenta A, Shanahan T, Vienings T, Jewkes R, Garcia-Moreno C, Naved RT, Jinadasa K, Vienings T, Kusuma W, Jewkes R, Connell R, Barker G, Greig A, Roy R, Verma R, Sen KM, Flood M, Johnson S., Lancet Glob Health 1(4), 2013
PMID: 25104345
Women's experience of intimate partner violence in Haiti.
Gage AJ., Soc Sci Med 61(2), 2005
PMID: 15893051
Gage AJ., Soc Sci Med 61(2), 2005
PMID: 15893051
Risk factors for domestic violence: findings from a South African cross-sectional study.
Jewkes R, Levin J, Penn-Kekana L., Soc Sci Med 55(9), 2002
PMID: 12297246
Jewkes R, Levin J, Penn-Kekana L., Soc Sci Med 55(9), 2002
PMID: 12297246
Domestic violence in rural Uganda: evidence from a community-based study.
Koenig MA, Lutalo T, Zhao F, Nalugoda F, Wabwire-Mangen F, Kiwanuka N, Wagman J, Serwadda D, Wawer M, Gray R., Bull. World Health Organ. 81(1), 2003
PMID: 12640477
Koenig MA, Lutalo T, Zhao F, Nalugoda F, Wabwire-Mangen F, Kiwanuka N, Wagman J, Serwadda D, Wawer M, Gray R., Bull. World Health Organ. 81(1), 2003
PMID: 12640477
A community mobilisation intervention to prevent violence against women and reduce HIV/AIDS risk in Kampala, Uganda (the SASA! Study): study protocol for a cluster randomised controlled trial.
Abramsky T, Devries K, Kiss L, Francisco L, Nakuti J, Musuya T, Kyegombe N, Starmann E, Kaye D, Michau L, Watts C., Trials 13(), 2012
PMID: 22747846
Abramsky T, Devries K, Kiss L, Francisco L, Nakuti J, Musuya T, Kyegombe N, Starmann E, Kaye D, Michau L, Watts C., Trials 13(), 2012
PMID: 22747846
Obot IS, Room R., 2005
Screening for depression and PTSD in a Cambodian population unaffected by war: comparing the Hopkins Symptom Checklist and Harvard Trauma Questionnaire with the structured clinical interview.
Silove D, Manicavasagar V, Mollica R, Thai M, Khiek D, Lavelle J, Tor S., J. Nerv. Ment. Dis. 195(2), 2007
PMID: 17299303
Silove D, Manicavasagar V, Mollica R, Thai M, Khiek D, Lavelle J, Tor S., J. Nerv. Ment. Dis. 195(2), 2007
PMID: 17299303
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