Adolescents with PTSD history more likely to struggle with substance abuse

By Jess Peterson, Staff writer

Adolescents who struggle with substance abuse are likely to carry the behavior over into their adult life, unless they are able to successfully receive treatment. Unfortunately, most adolescents only enter treatment in times of crisis or when it is absolutely required, hindering the potential for long-term success.

But Jordan Davis, a doctoral student in social work, has proposed a different solution.

“I call this the dentist model, because you see the dentist every six months,” Davis said. “So why wouldn’t we check in with mental health or substance abuse treatment? Why would you leave treatment expecting to be completely fine instead of coming in every three months, every six months, seeing what needs of that individual need to be met?”

In the past four years, Davis and Joey Merrin, a doctoral student in child development, have been merging their respective specializations on various projects. In combining Davis’ study of substance abuse treatment and Merrin’s focus on delinquency, both within the adolescent range, the two have published research papers about their analyzed data.

“I know we enjoy spending our weekends together on different analyses, trying to figure it out and answer questions,” Merrin said with a laugh.

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The pair’s strategy for analyzing longitudinal data is different than most other approaches as each study examines some aspect of victimization. By considering various socio-ecological factors, the studies compare which factor has the highest effect on entering an event.

The most recent study gathered information to predict what leads adolescents to re-enter substance abuse treatment by measuring elements of the subjects’ childhoods and how each element impacted the return to treatment.

“You can think about it as Russian dolls. The individual is nested within these different domains. Kids are nested in families which are nested in communities, kids are nested in schools,” Merrin said. “These different social ecologies …  interact with one another to affect the development of the child.”

Variables like peer delinquency, how many of an individual’s friends were arrested, parental hostility and parental warmth were taken into account. 

However, the results showed that when considering all other factors, the parental effect is diminished compared to an early diagnosis of PTSD in youth, which puts individuals at a 67 percent higher risk. Due to the recurring tendencies of PTSD, allowing for specialized treatment for individuals who experience the disorder may be better suited for the long-term healing process.

“Individuals entering treatment with a traumatic past are at risk for re-victimization, so we argued for a specialized kind of treatment for these folks and the idea that we might need to continue to check in,” Davis said.

Technology is beginning to change the game of identifying the factors affecting one’s likelihood of re-entering treatment. Applications designed for one to track their mood or substance intake have been developed and can be used as a preemptive measure rather than for emergencies. Taking the time to measure these aspects throughout an individual’s life can lead to greater awareness about when care or counseling may be needed. Davis even predicted future applications linking one’s treatment and healthcare provider to the client, which would result in a timelier opportunity for additional care.

“You would be able to see when the client is inputting data, and you might be able to get them at a point when they need treatment versus when they decide or are required to get treatment,” Davis said.

Influences from an environmental setting, within the neighborhood context, still hold an impact on individuals and the patterns experienced growing up. An issue facing these communities is a lack of resources, which can limit how much can be provided for those who are at risk of susceptibility to substance abuse.

Communities have challenges adapting to individuals, but by implementing community psychology at a larger scale or being provided with resources, there is the opportunity for greater positive impact.

“We’re trying to figure out cheaper alternatives in a way to try to mitigate individual risk in light of risky environments, risky families,” Merrin said. “Those are things we want to try and fix but they cost a lot of money, a lot of time.”

The results are meant to target the medical community, and Merrin and Davis look to have their paper published in medical and substance abuse journals. By attempting to find the points when substance abuse may most likely occur in adolescents, the hope is to reduce the continuation into adulthood with the tendency for abuse, which can also affect criminal activity.

Considering the different factors that influence one’s life and addressing the problem from a long-term lens provides for an attitude of optimism when considering development down the road. Davis and Merrin view their findings as an additional insight contributing to the prevention of prolonged substance abuse in adolescents and they plan to build on their research with the studies to come.

“We can find entry points for intervention and treatment efforts which will have a good chance of treating substance abuse,” Merrin said. “Understanding how context influences trauma and how trauma influences substance abuse really allows us the chance to step in to try and stop that trajectory of substance abuse leading into adulthood.”

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