Written By Alexis Mitchell UNCC ’18
Trauma survivors are of particular interest in stress research because they have experienced extreme stress due to their exposure to events such as combat, physical assault, sexual assault, and natural disasters. These individuals frequently report poor physical health, increased use of health care systems, and increased functional impairment as result of their trauma exposure (Flood et al., 2008). There is a behavioral pathway theory that has been extensively researched and suggests that posttraumatic stress disorder (PTSD) may lead to risky health behaviors, which in turn result in adverse health outcomes. Such risky behaviors include, but are not limited to, drug and alcohol use, smoking, and risky sexual behavior.
Flood and colleagues sought to investigate the connection between PTSD and adverse health outcomes in a sample of male and female college students (2008). A goal of their study was to determine whether high-risk behaviors, specifically substance abuse and smoking, influenced the relationship between PTSD and adverse health outcomes. In order to examine this, participants completed questionnaires that measured possible PTSD symptoms, physical health functioning, and substance use behaviors. Participants were 136 undergraduate students with 82% being female, and ages ranging from 17-24 years old.
Results suggested that the higher the individual scored on the PTSD symptom scale (PTSD checklist), indicating more symptoms of PTSD, the more health complaints they had. In addition, the PTSD symptom of “avoidance” was strongly related to negative health outcomes and increased hospital and health care visits. Avoidance is the act of avoiding thoughts, emotions, and actions that have anything to do with traumatic stimuli (stimuli that is directly related to the traumatic event experienced). Supporting the original hypothesis, the findings suggested that the more PTSD symptoms someone had, the more likely they were to frequently use alcohol, develop alcohol abuse problems, smoke more cigarettes per day, and abuse drugs. Those with high levels of PTSD symptomology engaged in drug and alcohol use frequently and in severely excessive amounts. This finding suggests that individuals with PTSD may engage in drug and alcohol use as a means of self-medication to regulate painful emotions. Avoidance and self-medication through substance use may work as an immediate or short-term coping strategy, but, if continued over time, they could result in damage to bodily systems and significant adverse health outcomes.
Furthermore, to support the behavioral pathway theory, individuals with PTSD may find engagement in health risk behaviors as an attempt to cope with high levels of emotional distress related to PTSD. This implication is important to keep in mind when providing therapy and interventions with those suffering from PTSD and substance abuse problems.
Flood et al. (2008) Substance use behaviors as a mediator between posttraumatic stress disorder and physical health in trauma-exposed college students. Journal of Behavioral Medicine, 32(3), 234-243.