Commentary on Reed PL, Anthony JC, & Breslau N.
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Question: Is post-traumatic stress disorder (PTSD) associated with risk of new drug problems? People: 988 young adults (aged 19-24 years) who had enrolled in a large cohort study while in first grade and followed through primary and middle school and on into adulthood. Of the original 2311 participants, only those at risk of a new drug use disorder (those without lifetime DSM-IV drug dependence, and who did not have clinical features of DSM-IV drug abuse or dependence in the previous 12 months) were included in this study. Due to funding problems, not all of these 1436 people were followed up and 988 were included in the final analysis. Setting: Participants recruited in 19 primary public schools in 5 urban areas in a large city in the USA; enrolment 1985-6, follow-up to 2002. Risk factors: The main risk factors of interest were lifetime exposure to at least one DSM-IV-qualifying traumatic event in the absence of post-traumatic stress disorder (PTSD), and PTSD following exposure to a traumatic event (diagnosed using WHO Composite International Diagnostic Interview). Family socioeconomic status, conduct problems, cognitive ability and academic achievement and risk-taking at the time of school entry were included in regression models as potential confounders, as were gender, age, ethnicity and the number of years of education completed. Outcomes: Incident cases of drug abuse or dependence (according to DSM-IV). The outcome was defined in one of four ways: drug abuse or dependence-1 or more DSM-IV clinical features of drug abuse or 2 or more DSM-IV clinical features with respect to any of 12 illegal or prescription drugs; drug abuse-1 or more DSM-IV clinical features of drug abuse (without the presence of DSM-IV drug dependence); drug dependence-3 or more DSM-IV clinical features of drug dependence with respect to any of 12 illegal or prescription drugs (with or without DSM-IV drug abuse); or emerging drug dependence problems-1 or 2 newly incident clinical features of drug dependence without the presence of clinical features of drug abuse.
Evidence-Based Mental Health
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Health, Clinical and Counselling Psychology