Coping motives mediate the relationship between PTSD and MDMA use in adolescents with substance use disorders

Abstract Background Post-traumatic stress disorder (PTSD) and substance use disorders (SUDs) often co-occur in adolescent patients. Previous research has shown that these patients differ from SUD patients without PTSD in terms of their substance use patterns. In this study, we aimed to test whether...

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Main Authors: Lukas Andreas Basedow, Melina Felicitas Wiedmann, Veit Roessner, Yulia Golub, Sören Kuitunen-Paul
Format: Article
Language:English
Published: BMC 2022-09-01
Series:Addiction Science & Clinical Practice
Subjects:
Online Access:https://doi.org/10.1186/s13722-022-00329-y
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author Lukas Andreas Basedow
Melina Felicitas Wiedmann
Veit Roessner
Yulia Golub
Sören Kuitunen-Paul
author_facet Lukas Andreas Basedow
Melina Felicitas Wiedmann
Veit Roessner
Yulia Golub
Sören Kuitunen-Paul
author_sort Lukas Andreas Basedow
collection DOAJ
description Abstract Background Post-traumatic stress disorder (PTSD) and substance use disorders (SUDs) often co-occur in adolescent patients. Previous research has shown that these patients differ from SUD patients without PTSD in terms of their substance use patterns. In this study, we aimed to test whether substance use in this population is related to an attempt to self-medicate PTSD-related symptoms. Methods German adolescent patients (aged 13–18 years) at an outpatient clinic for SUD treatment, n = 111 (43% female), completed a self-designed questionnaire on use motives, a measure of PTSD-related experiences, and underwent a standardized psychiatric interview including structured substance use questions. Participants were subsequently classified as ‘no traumatic experiences (‘noTEs’ but SUD), ‘traumatic experiences but no current PTSD diagnosis’ (‘TEs’ with SUD), and ‘PTSD’ with SUD. After establishing a self-designed motive measurement through exploratory and confirmatory factor analyses, we calculated non-parametric group differences and a mediation analysis in a linear regression framework. Results The past-year frequency of MDMA use was highest in the PTSD group and lowest in the noTE group (H (2) = 7.2, p = .027, η 2  = .058), but no differences were found for frequencies of tobacco, alcohol, cannabis, or stimulant use (all H ≤ 4.9, p ≥ .085, η 2  ≤ .033). While controlling for sex, the three groups showed a similar pattern (highest in the PTSD group and lowest in the noTE group) for coping scores (F (103) = 5.77, p = .004, η 2  = .101). Finally, mediation analyses revealed an indirect effect of coping score (b = 0.61, 95% CI [0.29, 1.58], p = .145) on the association between group membership and MDMA use frequency. Conclusions In adolescent SUD patients, we found an association of current PTSD and lifetime traumatic experiences with higher MDMA use that could be partially explained by substance use being motivated by an attempt to cope with mental health symptoms. This indicates a coping process involved specifically in MDMA use compared to the use of other psychoactive substances, possibly due to unique psychoactive effects of MDMA.
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spelling doaj.art-035eb986c145431594ddc3df4fa95d3b2022-12-22T03:12:23ZengBMCAddiction Science & Clinical Practice1940-06402022-09-0117111010.1186/s13722-022-00329-yCoping motives mediate the relationship between PTSD and MDMA use in adolescents with substance use disordersLukas Andreas Basedow0Melina Felicitas Wiedmann1Veit Roessner2Yulia Golub3Sören Kuitunen-Paul4Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität DresdenDepartment of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität DresdenDepartment of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität DresdenDepartment of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität DresdenDepartment of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität DresdenAbstract Background Post-traumatic stress disorder (PTSD) and substance use disorders (SUDs) often co-occur in adolescent patients. Previous research has shown that these patients differ from SUD patients without PTSD in terms of their substance use patterns. In this study, we aimed to test whether substance use in this population is related to an attempt to self-medicate PTSD-related symptoms. Methods German adolescent patients (aged 13–18 years) at an outpatient clinic for SUD treatment, n = 111 (43% female), completed a self-designed questionnaire on use motives, a measure of PTSD-related experiences, and underwent a standardized psychiatric interview including structured substance use questions. Participants were subsequently classified as ‘no traumatic experiences (‘noTEs’ but SUD), ‘traumatic experiences but no current PTSD diagnosis’ (‘TEs’ with SUD), and ‘PTSD’ with SUD. After establishing a self-designed motive measurement through exploratory and confirmatory factor analyses, we calculated non-parametric group differences and a mediation analysis in a linear regression framework. Results The past-year frequency of MDMA use was highest in the PTSD group and lowest in the noTE group (H (2) = 7.2, p = .027, η 2  = .058), but no differences were found for frequencies of tobacco, alcohol, cannabis, or stimulant use (all H ≤ 4.9, p ≥ .085, η 2  ≤ .033). While controlling for sex, the three groups showed a similar pattern (highest in the PTSD group and lowest in the noTE group) for coping scores (F (103) = 5.77, p = .004, η 2  = .101). Finally, mediation analyses revealed an indirect effect of coping score (b = 0.61, 95% CI [0.29, 1.58], p = .145) on the association between group membership and MDMA use frequency. Conclusions In adolescent SUD patients, we found an association of current PTSD and lifetime traumatic experiences with higher MDMA use that could be partially explained by substance use being motivated by an attempt to cope with mental health symptoms. This indicates a coping process involved specifically in MDMA use compared to the use of other psychoactive substances, possibly due to unique psychoactive effects of MDMA.https://doi.org/10.1186/s13722-022-00329-yAddictionDrugsEcstasySelf-medicationTrauma disorders
spellingShingle Lukas Andreas Basedow
Melina Felicitas Wiedmann
Veit Roessner
Yulia Golub
Sören Kuitunen-Paul
Coping motives mediate the relationship between PTSD and MDMA use in adolescents with substance use disorders
Addiction Science & Clinical Practice
Addiction
Drugs
Ecstasy
Self-medication
Trauma disorders
title Coping motives mediate the relationship between PTSD and MDMA use in adolescents with substance use disorders
title_full Coping motives mediate the relationship between PTSD and MDMA use in adolescents with substance use disorders
title_fullStr Coping motives mediate the relationship between PTSD and MDMA use in adolescents with substance use disorders
title_full_unstemmed Coping motives mediate the relationship between PTSD and MDMA use in adolescents with substance use disorders
title_short Coping motives mediate the relationship between PTSD and MDMA use in adolescents with substance use disorders
title_sort coping motives mediate the relationship between ptsd and mdma use in adolescents with substance use disorders
topic Addiction
Drugs
Ecstasy
Self-medication
Trauma disorders
url https://doi.org/10.1186/s13722-022-00329-y
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