Psychopathology Exam Notes
Theme 2
Substance abuse and PTSD comorbidity
• In the relatively few studies which have assessed post-traumatic stress disorder (PTSD), this
disorder has emerged as a common co-occurring diagnosis among substance abusers
• little is known about the impact of PTSD on outcome following substance abuse treatment
• describes the constellation of symptoms associated with exposure to extraordinary
traumatic events (e.g., childhood physical and/or sexual abuse, adulthood sexual assault,
combat, natural and technical disasters).
• PTSD is characterized by three classes of symptoms: (a) re-experiencing (e.g., nightmares,
'flashbacks'); (b) avoidance (e.g., efforts to avoid places reminiscent of the trauma) and
numbing of responsiveness (e.g., feelings of detachment or estrangement); and (c)
hyperarousal (e.g., extreme startle reactions).
• This disorder is among the most extreme reactions that individuals can have to high
magnitude life events and can result in severe and chronic impairment across the major life
areas.
• The link between PTSD and substance abuse appears to be particularly complex with cause-
and-effect relationships difficult to disentangle and determine.
• PTSD develops first and that chemical substances are used as a means of achieving symptom
relief
• Anecdotal evidence suggests that PTSD patients report using alcohol and/or drugs to
overcome the distress of trauma-related events and 'to forget' intrusive, disturbing
memories of the trauma
• the PTSD-substance abuse literature, as well as the general 'dual diagnosis' literature, shows
little evidence of specificity of substance use.
• the self-medication hypothesis but rather reflect a more complex relationship between the
separate symptom clusters of PTSD (i.e., re-experiencing, avoidance/numbing and
hyperarousal) and the type of substance used.
e.g. patients with PTSD characterized primarily by avoidance may use central nervous
system stimulants (e.g., amphetamines) to boost sociability, whereas PTSD patients
experiencing predominantly sleep difficulties and irritability/agitation may prefer to use
sedatives (e.g., alcohol)
Theme 2
Substance abuse and PTSD comorbidity
• In the relatively few studies which have assessed post-traumatic stress disorder (PTSD), this
disorder has emerged as a common co-occurring diagnosis among substance abusers
• little is known about the impact of PTSD on outcome following substance abuse treatment
• describes the constellation of symptoms associated with exposure to extraordinary
traumatic events (e.g., childhood physical and/or sexual abuse, adulthood sexual assault,
combat, natural and technical disasters).
• PTSD is characterized by three classes of symptoms: (a) re-experiencing (e.g., nightmares,
'flashbacks'); (b) avoidance (e.g., efforts to avoid places reminiscent of the trauma) and
numbing of responsiveness (e.g., feelings of detachment or estrangement); and (c)
hyperarousal (e.g., extreme startle reactions).
• This disorder is among the most extreme reactions that individuals can have to high
magnitude life events and can result in severe and chronic impairment across the major life
areas.
• The link between PTSD and substance abuse appears to be particularly complex with cause-
and-effect relationships difficult to disentangle and determine.
• PTSD develops first and that chemical substances are used as a means of achieving symptom
relief
• Anecdotal evidence suggests that PTSD patients report using alcohol and/or drugs to
overcome the distress of trauma-related events and 'to forget' intrusive, disturbing
memories of the trauma
• the PTSD-substance abuse literature, as well as the general 'dual diagnosis' literature, shows
little evidence of specificity of substance use.
• the self-medication hypothesis but rather reflect a more complex relationship between the
separate symptom clusters of PTSD (i.e., re-experiencing, avoidance/numbing and
hyperarousal) and the type of substance used.
e.g. patients with PTSD characterized primarily by avoidance may use central nervous
system stimulants (e.g., amphetamines) to boost sociability, whereas PTSD patients
experiencing predominantly sleep difficulties and irritability/agitation may prefer to use
sedatives (e.g., alcohol)
