Substance use to regulate intense posttraumatic shame in individuals with childhood abuse and neglect

TY - JOUR

T1 - Substance use to regulate intense posttraumatic shame in individuals with childhood abuse and neglect

AU - Holl, Julia

AU - Wolff, Sebastian

AU - Schumacher, Maren

AU - Höcker, Anja

AU - Arens, Elisabeth A

AU - Spindler, Gabriela

AU - Stopsack, Malte

AU - Südhof, Jonna

AU - Hiller, Philipp

AU - Klein, Michael

AU - Schäfer, Ingo

AU - Barnow, Sven

AU - CANSAS Study Group

AU - Bullinger, Monika

PY - 2017/8

Y1 - 2017/8

N2 - Childhood abuse and neglect (CAN) is considered as a risk factor for substance use disorder (SUD). Based on the drinking to cope model, this study investigated the association of two trauma-relevant emotions (shame and sadness) and substance use. Using ecological momentary assessment we compared real-time emotion regulation in situations with high and low intensity of shame and sadness in currently abstinent patients with CAN and lifetime SUD (traumaSUD group), healthy controls with CAN (traumaHC group), and without CAN (nontraumaHC group). Multilevel analysis showed a positive linear relationship between high intensity of both emotions and substance use for all groups. The traumaSUD group showed heightened substance use in low, as well as in high, intensity of shame and sadness. In addition, we found an interaction between type of emotion, intensity, and group: the traumaHC group exhibited a fourfold increased risk for substance use in high intense shame situations relative to the traumaSUD group. Our findings provide evidence for the drinking to cope model. The traumaSUD group showed a reduced distress tolerance for variable intensity of negative emotions. The differential effect of intense shame for the traumaHC group emphazises its potential role in the development of SUD following CAN. In addition, shame can be considered a relevant focus for therapeutic preinterventions and interventions for SUD after CAN.

AB - Childhood abuse and neglect (CAN) is considered as a risk factor for substance use disorder (SUD). Based on the drinking to cope model, this study investigated the association of two trauma-relevant emotions (shame and sadness) and substance use. Using ecological momentary assessment we compared real-time emotion regulation in situations with high and low intensity of shame and sadness in currently abstinent patients with CAN and lifetime SUD (traumaSUD group), healthy controls with CAN (traumaHC group), and without CAN (nontraumaHC group). Multilevel analysis showed a positive linear relationship between high intensity of both emotions and substance use for all groups. The traumaSUD group showed heightened substance use in low, as well as in high, intensity of shame and sadness. In addition, we found an interaction between type of emotion, intensity, and group: the traumaHC group exhibited a fourfold increased risk for substance use in high intense shame situations relative to the traumaSUD group. Our findings provide evidence for the drinking to cope model. The traumaSUD group showed a reduced distress tolerance for variable intensity of negative emotions. The differential effect of intense shame for the traumaHC group emphazises its potential role in the development of SUD following CAN. In addition, shame can be considered a relevant focus for therapeutic preinterventions and interventions for SUD after CAN.

U2 - 10.1017/S0954579416000432

DO - 10.1017/S0954579416000432

M3 - SCORING: Journal article

C2 - 27292103

VL - 29

SP - 737

EP - 749

JO - DEV PSYCHOPATHOL

JF - DEV PSYCHOPATHOL

SN - 0954-5794

IS - 3

ER -