A population-based study of help seeking and self-medication among trauma-exposed individuals

Psychol Addict Behav. 2016 Nov;30(7):771-777. doi: 10.1037/adb0000185. Epub 2016 Jun 6.

Abstract

Epidemiologic studies of trauma highlight the imbalance between prevalence of psychiatric diagnoses and help seeking. We investigated prevalence and correlates of help seeking and self-medication in Norwegian adults with trauma history with a focus on common posttrauma outcomes of posttraumatic stress disorder (PTSD) and substance use disorders (alcohol or drug). Participants reporting at least 1 PTSD symptom (n = 307) were asked if they consulted with a doctor/another professional (help seeking) or used drugs/alcohol (self-medication) for trauma-related problems. PTSD, alcohol abuse or dependence (AUD), and drug use or dependence (DUD) were assessed via structured diagnostic interviews. Help seeking and self-medication were endorsed by 37.4% and 10.4% of the sample, respectively. As compared to the full sample, help seeking was endorsed at a greater rate in individuals with PTSD (χ2 = 8.59, p = .005) and at a lower rate in those with AUD (χ2 = 7.34, p < .004). Self-medication was more likely to be endorsed by individuals with PTSD than without PTSD (χ2 = 25.68, p < .001). In regression analyses, PTSD was associated with increased likelihood of self-medication (odds ratio [OR] = 4.56) and help seeking (OR = 2.29), while AUD was associated with decreased likelihood of help-seeking (OR = .29). When self-medication was included as a predictor, PTSD was no longer associated with help seeking, although AUD remained inversely associated. PTSD and AUDs have a nuanced relationship with formal help seeking as well as the use of substances to cope. Trauma-exposed individuals are likely engaging in adaptive and maladaptive coping strategies, the latter of which may be compounding distress. (PsycINFO Database Record

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Female
  • Help-Seeking Behavior*
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Self Medication
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / psychology*
  • Stress Disorders, Post-Traumatic / therapy
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / psychology*
  • Substance-Related Disorders / therapy