COSIG CONFERENCE BROCHURE.pdf - Drexel University College ...

COSIG Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006
PART 1: CHILDHOOD TRAUMA –
THE DIMENSIONS OF THE
PROBLEM
1. Medical and physical health consequences (cont.)
f. Sexual abuse predisposed to: drug and alcohol
addiction, unprotected sex, increased sexual
partners, prostitution, and HIV/AIDS.
g. Many individuals with dual diagnosis (MH and
D&A) have a history of trauma. Many also
develop PTSD.
PART 1: CHILDHOOD TRAUMA – THE
DIMENSIONS OF THE PROBLEM
2. Possible psychiatric and substance use disorders
(may coexist with, or be a consequence of,
trauma):
a. Psychiatric Disorders:
1) ODD/CD
2) ADHD
3) Depression
4) BPD or Mood Disorder NOS.
5) Intermittent Explosive Disorder
6) PTSD
7) Other anxiety disorder
8) Personality Disorder – Borderline, Narcissistic, Paranoid
9) Psychotic disorder
10) Other
PART 1: CHILDHOOD TRAUMA – THE
DIMENSIONS OF THE PROBLEM
2. Possible psychiatric and substance use disorders
(cont.)
b. Substance Use Disorders (SUD):
1) Alcohol
2) Drug use – stimulants, depressants, both.
Hallucinogens.
3) Mixed alcohol and drug use.
c. Co-occurring psychiatric and substance use disorder
– the rule, and the necessary clinical presumption.
PART 1: CHILDHOOD TRAUMA – THE
DIMENSIONS OF THE PROBLEM
3. Frequency of adult psychiatric disorders, in
individuals subjected to trauma as child/adolescent,
compared to adults without trauma exposure:
a. Affective disorder: almost 3 times more likely.
b. Anxiety disorder: almost 3 times more likely.
c. Phobia: almost 2 ½ times more likely.
d. Panic disorder: more than 10 times more likely.
e. Antisocial personality disorder: almost 4 times more likely.
f. Self-harm more likely: suicide attempts, cutting, selfstarving.
g. Auditory hallucinations and emergence of Schizophrenia
more likely.
h. PTSD or PTSD-related symptoms common [hyperarousal,
re-experiencing, and avoidance]
PART 1: CHILDHOOD TRAUMA – THE
DIMENSIONS OF THE PROBLEM
4. Increased substance use problems, and cooccurring
substance use and psychiatric disorders:
a. Substance abuse and co-occurring PTSD:
1) Up to 67% males and females seeking SUD RX have
PTSD – complete or partial.
2) 40-59% of women in substance abuse treatment have
PTSD.
3) Rate of SUD with co-occurring PTSD 2-3 times higher
for women than men.
4) Among consumers receiving SUD Rx, 33% with some
dissociative disorder.
PART 1: CHILDHOOD TRAUMA – THE
DIMENSIONS OF THE PROBLEM
4. Increased substance use problems, and cooccurring
substance use and psychiatric
disorders (cont.):
b. Frequency of childhood trauma in consumers with
SUD and any psychiatric disorder:
1) 55% of consumers at the Maine State Hospital with SUD
and one or more psychiatric disorders reported history of
childhood physical or sexual abuse.
c. Lack of detection of PTSD in mental health services:
1) Staff involved in inpatient and outpatient MH treatment
identified 2% of consumers as having PTSD.
2) Independent assessors of these same consumers found
45% as having PTSD (43% more).
3) To find out, need to ask.
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