Trastorno por estrés postraumático y trastorno por uso de sustancias entre adolescentes: Autoestigma y perspectiva de género

Autores/as

  • Anna Robert Segarra Psicológa clínica. Benito Menni CASM

DOI:

https://doi.org/10.21134/999

Palabras clave:

trauma, adolescents, self-stigma, substance use disorders, gender perspective

Resumen

Después de un acontecimiento traumático, las personas pueden tener una variedad de reacciones. La mayoría de personas superarán estos síntomas, pero es posible que algunas continúen teniéndolos pasado un tiempo, y cumplan criterios para un diagnóstico de trastorno por estrés postraumático (TEPT).

EL TEPT, por su definición, supone un problema de regulación emocional y conductual. Existen recuerdos intrusivos (o reviviscencias) que la persona procura evitar (o disociar), con un incremento de la hipervigilancia y la reactividad a estímulos que recuerdan al trauma, además de síntomas cognitivos y alteraciones del estado de ánimo. En clave de género, el diagnóstico de TEPT se ha asociado de 2 a 3 veces más al género femenino, tanto por cuestiones de regulación fisiológica, como por factores sociales y psicológicos (Olff, 2017).

Las estrategias poco adaptativas que la persona adopta para afrontar el estrés suponen una disregulación emocional, que está muy en relación con la presencia de problemas de salud mental y adicciones, tal y como desarrolla recientemente Latorre (2024) en una editorial de esta revista.

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Citas

Adams, Z. W., Hahn, A. M., McCart, M. R., Chapman, J. E., Sheidow, A. J., Walker, J., de Arellano, M., & Danielson, C. K. (2021). Predictors of substance use in a clinical sample of youth seeking treatment for Trauma-

related mental health problems. Addictive behaviors, 114, 106742. https://doi.org/10.1016/ j.addbeh.2020.106742

Basedow, L. A., Wiedmann, M. F., Roessner, V., Golub, Y., & Kuitunen-Paul, S. (2022). Coping motives

mediate the relationship between PTSD and MDMA use in adolescents with substance use disorders. Addiction science & clinical practice, 17(1), 46. https://doi.org/10.1186/s13722-022-00329-y

Benfer, N., Howell, M. K., Lucksted, A., Romero, E. G., & Drapalski, A. L. (2023). Self-Stigma and PTSD: Conceptualization and Implications for Research and Treatment. Psychiatric services (Washington, D.C.), 74(10), 1081–1083. https://doi.org/10.1176/appi.ps.20220397

Berenz, E. C., Edalatian Zakeri, S., Demos, A. P., Paltell, K. C., Bing-Canar, H., Kevorkian, S., & Ranney, R. (2021). Negative affect and alcohol craving in trauma-exposed young adult drinkers. Alcoholism, clinical and experimental research, 45(7), 1479–1493. https://doi.org/10.1111/acer.14641

Blakey, S. M., Yi, J. Y., Calhoun, P. S., Beckham, J. C., & Elbogen, E. B. (2019). Why do trauma survivors become depressed? Testing the behavioral model of depression in a nationally representative sample. Psychiatry research, 272, 587–594. https://doi.org/10.1016/j.psychres.2018.12.150

Blanco, L., Sió, A., Hogg, B., Esteve, R., Radua, J., Solanes, A., Gardoki-Souto, I., Sauras, R., Farré, A., Castillo, C., Valiente-Gómez, A., Pérez, V., Torrens, M., Amann, B. L., & Moreno-Alcázar, A. (2020). Traumatic Events in Dual Disorders: Prevalence and Clinical Characteristics. Journal of clinical medicine, 9(8), 2553. https:// doi.org/10.3390/jcm9082553

Bonfils, K. A., Lysaker, P. H., Yanos, P. T., Siegel, A., Leonhardt, B. L., James, A. V., Brustuen, B., Luedtke, B., & Davis, L. W. (2018). Self-stigma in PTSD: Prevalence and correlates. Psychiatry research, 265, 7–12. https:// doi.org/10.1016/j.psychres.2018.04.004

Bremer-Landau, J. D., & Caskie, G. I. L. (2019). Gender as Potential Moderator of Associations Among Trauma Exposure, Posttraumatic Stress Disorder Symptoms, and Alcohol Use Disorder Symptoms in Young Adults.

Journal of traumatic stress, 32(4), 586–594. https://doi.org/10.1002/jts.22419

Danielson, C. K., Adams, Z., McCart, M. R., Chapman, J. E., Sheidow, A. J., Walker, J., Smalling, A., & de Arellano, M. A. (2020). Safety and Efficacy of Exposure-Based Risk Reduction Through Family Therapy for Co- occurring Substance Use Problems and Posttraumatic Stress Disorder Symptoms Among Adolescents: A Randomized Clinical Trial. JAMA psychiatry, 77(6), 574–586. https://doi.org/10.1001/jamapsychiatry.2019.4803

Davis, J. P., Dworkin, E. R., Helton, J., Prindle, J., Patel, S., Dumas, T. M., & Miller, S. (2019). Extending poly- victimization theory: Differential effects of adolescents' experiences of victimization on substance use disorder diagnoses upon treatment entry. Child abuse & neglect, 89, 165–177. https://doi.org/10.1016/j.chiabu.2019.01.009

Davis, J. P., Christie, N. C., Dworkin, E. R., Prindle, J., Dumas, T. M., DiGuiseppi, G., Helton, J. J., & Ring, C. (2020). Influences of victimization and comorbid conditions on latency to illicit drug use among adolescents and young adults. Drug and alcohol dependence, 206, 107721. https://doi.org/10.1016/ j.drugalcdep.2019.107721

DiGuiseppi, G. T., Ring, C. R., Rice, E. R., & Davis, J. P. (2022). Sex differences in poly-victimization among youth experiencing homelessness prior to substance use treatment. Child abuse & neglect, 129, 105670. https:// doi.org/10.1016/j.chiabu.2022.105670

Ellenbogen, S., Colin-Vezina, D., Sinha, V., Chabot, M., & Wells, S. J. R. (2018). Contrasting mental health correlates of physical and sexual abuse-related shame. Journal of child and adolescent mental health, 30(2), 87–97. https://doi.org/10.2989/17280583.2018.1485569

Freeman, T. E., Jordan, H. R., & Madson, M. B. (2020). Coping Styles Mediate the Association between Posttraumatic Stress Disorder Symptoms and Alcohol Outcomes in College Students. Substance use & misuse, 55(14), 2371–2378. https://doi.org/10.1080/10826084.2020.1817083

Hahn, A. M., Adams, Z. W., Chapman, J., McCart, M. R., Sheidow, A. J., de Arellano, M. A., & Danielson, C. K.

(2020). Risk reduction through family therapy (RRFT): Protocol of a randomized controlled efficacy trial of

Health and Addictions / Salud y Drogas. Vol. 24 (2) 1-8 2024.

an integrative treatment for co-occurring substance use problems and posttraumatic stress disorder symptoms in adolescents who have experienced interpersonal violence and other traumatic events. Contemporary clinical trials, 93, 106012. https://doi.org/10.1016/j.cct.2020.106012

Hawn, S. E., Bountress, K. E., Sheerin, C. M., Dick, D. M., & Amstadter, A. B. (2020). Trauma-related drinking to cope: A novel approach to the self-medication model. Psychology of addictive behaviors: journal of the Society of Psychologists in Addictive Behaviors, 34(3), 465–476. https://doi.org/10.1037/adb0000552

Jordan, H. R., Madson, M. B., Nicholson, B. C., Bravo, A. J., Pearson, M. R., & Protective Strategies Study Team (2019). Posttraumatic stress disorder symptoms and problematic alcohol use in college students: The moderating role of alcohol protective behavioral strategies and gender. Psychological trauma: theory, research, practice and policy, 11(3), 247–255. https://doi.org/10.1037/tra0000417

Jordan, H. R., Madson, M. B., Bravo, A. J., Pearson, M. R., & Protective Strategies Study Team (2020). Post- traumatic stress and marijuana outcomes: The mediating role of marijuana protective behavioral strategies. Substance abuse, 41(3), 375–381. https://doi.org/10.1080/08897077.2019.1635965

Latorre, J. M. (2024). Regulación emocional: un nuevo desafío en la comprensión y el tratamiento de las adicciones. Health and Addictions/Salud Y Drogas, 24(1), 1–8. https://doi.org/10.21134/haaj.v24i1.954

Lee, J. Y., Brook, J. S., Finch, S. J., Kim, W., & Brook, D. W. (2019). Single and dual diagnoses of major depressive disorder and posttraumatic stress disorder predicted by triple comorbid trajectories of tobacco, alcohol, and marijuana use among urban adults. Substance abuse, 40(2), 221–228. https://doi.org/10.1080/08897077.2019.1572047

Melchior, H., Hüsing, P., Grundmann, J., Lotzin, A., Hiller, P., Pan, Y., Driessen, M., Scherbaum, N., Schneider, B., Hillemacher, T., Stolzenburg, S., Schomerus, G., Schäfer, I., & Cansas Study Group (2019). Substance Abuse- Related Self-Stigma in Women with Substance Use Disorder and Comorbid Posttraumatic Stress Disorder.

European addiction research, 25(1), 20–29. https://doi.org/10.1159/000496113

Mills, K. L., Barrett, E., Back, S. E., Cobham, V. E., Bendall, S., Perrin, S., Brady, K. T., Ross, J., Peach, N., Kihas, I., Cassar, J., Schollar-Root, O., & Teesson, M. (2020). Randomised controlled trial of integrated trauma-focused psychotherapy for traumatic stress and substance use among adolescents: trial protocol. BMJ open, 10(11), e043742. https://doi.org/10.1136/bmjopen-2020-043742

Moreland, A. D., Walsh, K., Hartley, C., Hanson, R., Danielson, C. K., Saunders, B., & Kilpatrick, D. G. (2018). Investigating Longitudinal Associations Between Sexual Assault, Substance Use, and Delinquency Among Female Adolescents: Results From a Nationally Representative Sample. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 63(3), 320–326. https://doi.org/10.1016/j.jadohealth.2018.04.002

Narvaez, J. C. M., Remy, L., Bermudez, M. B., Scherer, J. N., Ornell, F., Surratt, H., Kurtz, S. P., & Pechansky, F. (2019). Re-traumatization Cycle: Sexual Abuse, Post-Traumatic Stress Disorder and Sexual Risk Behaviors among Club Drug Users. Substance use & misuse, 54(9), 1499–1508. https://doi.org/10.1080/10826084.2019.1589521

Olff, M. (2017). Sex and gender differences in post-traumatic stress disorder: an update. European Journal of Psychotraumatology, 8(sup4), 1351204. https://doi.org/10.1080/20008198.2017.1351204

Organización Mundial de la Salud. (2019). Clasificación estadística internacional de enfermedades y problemas de salud relacionados (11ª ed.). https://icd.who.int/

Pahl, K., Williams, S. Z., Lee, J. Y., Joseph, A., & Blau, C. (2020). Trajectories of violent victimization predicting PTSD and comorbidities among urban ethnic/racial minorities. Journal of consulting and clinical psychology, 88(1), 39–47. https://doi.org/10.1037/ccp0000449

Paltell, K. C., Smith, R. L., Kansky, J., Cox, C. M., Amstadter, A. B., Dick, D., The Spit For Science Working Group, Salvatore, J. E., & Berenz, E. C. (2020). Posttraumatic stress disorder symptoms, relationship quality, and risky alcohol use among trauma-exposed students. Addictive behaviors, 102, 106216. https://doi.org/10.1016/j.addbeh.2019.106216

Park, T., Thompson, K., Wekerle, C., Al-Hamdani, M., Smith, S., Hudson, A., Goldstein, A., & Stewart, S. H. (2019). Posttraumatic Stress Symptoms and Coping Motives Mediate the Association Between Childhood Maltreatment and Alcohol Problems. Journal of traumatic stress, 32(6), 918–926. https://doi.org/10.1002/jts.22467

Rodriguez, L., & Read, J. P. (2020). Momentary emotional responding and emotion regulation in PTSD-related drinking urge. Experimental and clinical psychopharmacology, 28(1), 99–111. https://doi.org/10.1037/pha0000292

Sonnier, H., Alex Brake, C., Flores, J., & Badour, C. L. (2019). Posttraumatic stress and hazardous alcohol use in trauma-exposed young adults: indirect effects of self-disgust. Substance use & misuse, 54(7), 1051–1059. https://doi.org/10.1080/10826084.2018.1517173

Subbie-Saenz de Viteri, S., Pandey, A., Pandey, G., Kamarajan, C., Smith, R., Anokhin, A., Bauer, L., Bender, A., Chan, G., Dick, D., Edenberg, H., Kinreich, S., Kramer, J., Schuckit, M., Zang, Y., McCutcheon, V., Bucholz, K., Porjesz, B., & Meyers, J. L. (2020). Pathways to post-traumatic stress disorder and alcohol dependence: Trauma, executive functioning, and family history of alcoholism in adolescents and young adults. Brain and behavior, 10(11), e01789. https://doi.org/10.1002/brb3.1789

Witte, T. H., Weymouth, B. B., Gajos, J. M., Penunuri, A., & Levy, S. (2020). Trauma Exposure and Problem Drinking in Late Adolescence: A Latent Profile Analysis. Journal of traumatic stress, 33(6), 1048–1059. https:// doi.org/10.1002/jts.22599

Yeo, E. J., Hlongwane, K., Otwombe, K., Hopkins, K. L., Variava, E., Martinson, N., Strathdee, S. A., Coetzee, J., & Milovanovic, M. (2022). Key risk factors for substance use among female sex workers in Soweto and Klerksdorp, South Africa: A cross-sectional study. PloS one, 17(1), e0261855. https://doi.org/10.1371/journal.pone.0261855

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Publicado

2024-08-02

Cómo citar

Robert Segarra, A. (2024). Trastorno por estrés postraumático y trastorno por uso de sustancias entre adolescentes: Autoestigma y perspectiva de género. Health and Addictions/Salud Y Drogas, 24(2), 1–8. https://doi.org/10.21134/999

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Editorial