Skip to main content

Advertisement

SpringerLink
Log in

Trauma and Psychosocial Predictors of Substance Abuse in Women Impacted by HIV/AIDS

  • Special Issue
  • Published:
The Journal of Behavioral Health Services & Research Aims and scope Submit manuscript

Abstract

The purpose of this study was to estimate the relative contributions of trauma, chronic stress burden, depression, anxiety, social support, and social undermining in predicting alcohol and drug abuse, and whether ethnicity moderated these relationships. A multi-ethnic sample of 288 HIV-positive and HIV-negative women was recruited. Multiple group path analysis indicated that greater drug dependence was associated with being HIV+, more depression, and higher chronic burden. Trauma was related only to anxiety. Also, greater alcohol dependence was associated with more depression and more social undermining, and these effects were moderated by ethnicity. African American and Latina women evidenced different relationships between depression, social support and social undermining. Depression, social support and social undermining served as intervening variables in influencing the relationships between the other psychosocial variables and drug and alcohol dependence. The implications of these findings for alcohol and drug abuse research and services are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3
Figure 4

Similar content being viewed by others

References

  1. Cohen S, Herbert TB. Health psychology: psychological factors and physical disease from the perspective of human psychoneuroimmunology. Annual Review of Psychology. 1996;47:113–142 doi:10.1146/annurev.psych.47.1.113.

    Article  PubMed  CAS  Google Scholar 

  2. Wyatt GE, Vargas Carmona JV, Loeb TB, et al. HIV-positive black women with histories of childhood sexual abuse: patterns of substance use and barriers to health care. Journal of Health Care for the Poor and Underserved. 2005;16:9–23 doi:10.1353/hpu.2005.0120.

    Article  PubMed  Google Scholar 

  3. Bing E, Burnam MA, Longshore D, et al. Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Archives of General Psychiatry. 2001;58:721–728 doi:10.1001/archpsyc.58.8.721.

    Article  PubMed  CAS  Google Scholar 

  4. Liu H, Longshore D, Williams JK, et al. Substance abuse and medication adherence among HIV-positive women with histories of child sexual abuse. AIDS and Behavior. 2006;10:279–286 doi:10.1007/s10461-005-9041-y.

    Article  PubMed  Google Scholar 

  5. Merikangas KR, Mehta RL, Molnar BE, et al. Comorbidity of substance use disorders with mood and anxiety disorders: results from the international consortium in psychiatric epidemiology. Addiction Behavior. 1988;23:893–907 doi:10.1016/S0306-4603(98)00076-8.

    Article  Google Scholar 

  6. Turner BJ, Fleishman JA, Wenger N, et al. Effects of drug abuse and mental disorders on use and type of antiretroviral therapy in HIV-infected persons. Journal of General Internal Medicine. 2001;16:625–633 doi:10.1046/j.1525-1497.2001.016009625.x.

    Article  PubMed  CAS  Google Scholar 

  7. Center for Disease Control and Prevention (CDC). Fact Sheet: HIV/AIDS among African Americans. http://www.cdc.gov.hiv/pubs/facts/AfricanAmerican.html.html. Accessed August 5, 2007.

  8. Lang AJ, Rodger CS, Laffaye C, et al. Sexual trauma, posttraumatic stress disorder, and health behavior. Behavioral Medicine. 2003;28:150–158.

    PubMed  Google Scholar 

  9. Wyatt GE, Myers HF, Williams JK, et al. Does a history of trauma contribute to HIV risk for women of color? Implications for prevention and policy. American Journal of Public Health. 2002;92:660–665.

    Article  PubMed  Google Scholar 

  10. Larson MJ, Miller L, Becker M, et al. Physical health burdens of women with trauma histories and co-occurring substance abuse and mental disorders. The Journal of Behavioral Health Services and Research. 2005;32:1094–3412.

    Google Scholar 

  11. Resnick HS, Kilpatrick DS, Danski BS, et al. Prevalence of civilian trauma and posttraumatic stress disorder in a representative national sample of women. Journal of Consulting and Clinical Psychology. 1993;61:984–991 doi:10.1037/0022-006X.61.6.984.

    Article  PubMed  CAS  Google Scholar 

  12. Pole N, Best SR, Weiss DS, et al. Effects of gender and ethnicity on duty-related posttraumatic stress symptoms among urban police officers. Journal of Nervous and Mental Disease. 2001;189:442–448 doi:10.1097/00005053-200107000-00005.

    Article  PubMed  CAS  Google Scholar 

  13. Breslau N, Kessler RC, Chilcoat HD. Trauma and posttraumatic stress disorder in the community: the 1996 Detroit Area Survey of Trauma. Archives of General Psychiatry. 1998;52:1048–1060.

    Google Scholar 

  14. Jacobsen LK, Southwick SM, Kosten TR. Substance use disorders in patients with posttraumatic stress disorder: a review of literature. The American Journal of Psychiatry. 2001;158:1184–1190 doi:10.1176/appi.ajp.158.8.1184.

    Article  PubMed  CAS  Google Scholar 

  15. Kilpatrick D, Resnick HS, Saunders BE, et al. Victimization, posttraumatic stress disorder, and substance use and abuse among women. International Journal of Addition. 1995;30:1079–1099.

    Google Scholar 

  16. Testa M, Parks KA. The role of women’s alcohol consumption in sexual victimization. Aggression and Violent Behavior. 1996;1:217–234 doi:10.1016/1359-1789(95)00017-8.

    Article  Google Scholar 

  17. West CM, Williams LM, Siegel JA. Adult sexual revictimization among black women sexually abused in childhood: a prospective examination of serious consequences of abuse. Child Maltreatment. 2000;5:49–57 doi:10.1177/1077559500005001006.

    Article  PubMed  CAS  Google Scholar 

  18. Sandanger I, Nygard JF, Sorensen T, et al. Is women’s mental health more susceptible than men’s to the influence of surrounding stress? Social Psychiatry & Epidemiology. 2004;39:177–184 doi:10.1007/s00127-004-0728-6.

    Article  Google Scholar 

  19. Tosevski DL, Milovancevic MP. Stressful life events and physical health. Current Opinion in Psychiatry. 2006;19:184–189 doi:10.1097/01.yco.0000214346.44625.57.

    Article  PubMed  Google Scholar 

  20. Amaro H, Larson MJ, Gampel J, et al. Racial/ethnic differences in social vulnerability among women with co-occurring mental health and substance abuse disorders: implications for treatment services. Journal of Community Psychology. 2005;33:495–511 doi:10.1002/jcop.20065.

    Article  Google Scholar 

  21. Gurung RAR, Taylor SE, Kemeny M, et al. “HIV is not my biggest problem”: the impact of HIV and chronic burden on depression in women at risk for AIDS. Journal of Social & Clinical Psychology. 2004;23(4):490–511 doi:10.1521/jscp.23.4.490.40305.

    Article  Google Scholar 

  22. Lesserman J, Whetten K, Lowe K, et al. How trauma, recent stressful events and PTSD affect functional health status and health utilization in HIV-infected patients in the south. Psychosomatic Medicine. 2005;67:500–507 doi:10.1097/01.psy.0000160459.78182.d9.

    Article  Google Scholar 

  23. Taylor SE, Seeman TE. Psychosocial resources and the SES-health relationship. Annals of the New York Academy of Sciences. 1999;896:210–225 doi:10.1111/j.1749-6632.1999.tb08117.x.

    Article  PubMed  CAS  Google Scholar 

  24. Sun A. Relapse among substance-abusing women: components and processes. Substance Use & Misuse. 2007;42:1–21 doi:10.1080/10826080601094082.

    Article  Google Scholar 

  25. Groh DR, Jason LA, Davis MI, et al. Friends, family, and alcohol abuse: an examination of general and alcohol-specific social support. The American Journal on Addictions. 2007;16:49 doi:10.1080/10550490601080084.

    Article  PubMed  Google Scholar 

  26. Chin D, Krosen K. Disclosure of HIV infection among Asian/Pacific Islander women: cultural stigma and support. Cultural Diversity and Ethnic Minority Psychology. 1999;5:222–226 doi:10.1037/1099-9809.5.3.222.

    Article  Google Scholar 

  27. Smith DW, Letourneau EJ, Saunders BE, et al. Delay in disclosure of childhood rape: results from a national survey. Child Abuse & Neglect. 2000;24(2):273–287 doi:10.1016/S0145-2134(99)00130-1.

    Article  CAS  Google Scholar 

  28. Vinokur A, Van Ryn M. Social support and undermining in close relationships: their independent effects on the mental health of unemployed persons. Journal of Personality and Social Psychology. 1993;65:350–359 doi:10.1037/0022-3514.65.2.350.

    Article  PubMed  CAS  Google Scholar 

  29. Wyatt GE, Lawrence J, Vodounon A, et al. The Wyatt sexual health questionnaire: a structured interview for female sexual history taking. Journal of Child Sexual Abuse. 1992;1:51–68 doi:10.1300/J070v01n04_04.

    Article  Google Scholar 

  30. Straus MA. Measuring intrafamily conflict and violence: the conflicts tactics (CT) scales. Journal of Marriage and the Family. 1979;4:75–88 doi:10.2307/351733.

    Article  Google Scholar 

  31. Radloff LS. The CES-D Scale: a self-report depression scale for research in the general population. Applied Psychological Measurement. 1977;1:385–401 doi:10.1177/014662167700100306.

    Article  Google Scholar 

  32. Derogatis LR, Rickels K, Rock AF. The SCL-90 and the MMPI: a step in the validation of a new self-report scale. British Journal of Psychiatry. 1976;128:280–289.

    Article  PubMed  CAS  Google Scholar 

  33. Sarason IG, Levine HM, Basham RB, et al. Assessing social support: the social support questionnaire. Journal of Personality and Social Psychology. 1983;44:127–139 doi:10.1037/0022-3514.44.1.127.

    Article  Google Scholar 

  34. Kessler RC, McGonagle KA, Zhao S. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the national comorbidity study. Archives of General Psychiatry. 1994;51:8–19.

    PubMed  CAS  Google Scholar 

  35. Byrne BM, Shavelson RJ, Muthén B. Testing the equivalence of factor covariance and mean structures: the issue of partial measurement invariance. Psychological Bulletin. 1989;105:456–466 doi:10.1037/0033-2909.105.3.456.

    Article  Google Scholar 

  36. Little RJA, Rubin DB. Statistical Analysis with Missing Data. New York: Wiley; 1987.

    Google Scholar 

  37. Schafer JL, Graham JW. Missing data: our view of the state of the art. Psychological Methods. 2002;7:147–177 doi:10.1037/1082-989X.7.2.147.

    Article  PubMed  Google Scholar 

  38. Satorra A, Bentler PM. Corrections to test statistics and standard errors in covariance structure analysis. In: von Eye A, Clogg CC, eds. Latent variables analysis: Applications for developmental research. Thousand Oaks, CA: Sage; 1994:399–419.

    Google Scholar 

  39. Bentler PM, Yuan K-H. Structural equation modeling with small samples: test statistics. Multivariate Behavioral Research. 1999;34:181–197 doi:10.1207/S15327906Mb340203.

    Article  Google Scholar 

  40. Hu L, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling. 1999;6:1–55.

    Article  Google Scholar 

  41. Ullman JB. Structural equation modeling. In: Tabachnick BG, Fidell LS, eds. Using multivariate statistics (5th Ed). New York, NY: Allyn & Bacon; 2007.

    Google Scholar 

  42. Bentler PM, Dijkstra T. Efficient estimation via linearization in structural models. In: Krishnaiah PR, ed. Multivariate analysis VI. Amsterdam: North Holland; 1985:9–42.

    Google Scholar 

  43. Satorra A, Bentler PM. A scaled difference chi-square test statistic for moment structure analysis. Psychometrika. 2001;66:507–514.

    Article  Google Scholar 

  44. Brady KT, Sinha R. Co-occurring mental and substance use disorders: the neurobiological effects of chronic stress. American Journal of Psychiatry. 2005;162:1483–1493.

    Article  PubMed  Google Scholar 

  45. Galvan FH, Caetano R. Alcohol use and related problems among ethnic minorities in the United States. Alcohol Research & Health. 2003;27:87–94.

    Google Scholar 

  46. Newcomb MD, Carmona JV. Adult trauma and HIV status among Latinas: effects upon psychological adjustment and substance use. AIDS and Behavior. 2004;8:417–428.

    Article  PubMed  Google Scholar 

  47. Zemore SE. Re-examining whether and why acculturation relates to drinking outcomes in a rigorous, national survey of Latinos. Alcohol Clinical & Experimental Research. 2006;2:2144–2153.

    Google Scholar 

Download references

Acknowledgments

This research was supported in part by the National Institute of Mental Health grants Nos. MH073453-01A1 and T32 MH17140, by the National Institute of Drug Abuse grant Nos. DA 01071-34 and DA-01070-34, and by The Pittsburgh Mind-Body Center (PMBC; NIH grant Nos. HL076852/076858). The authors dedicate this manuscript to the memory and the many contributions our colleague and friend, Douglas Longshore, Ph.D., made to the study of the psychosocial contributors to substance abuse.

Author information

Authors and Affiliations

  1. Department of Psychology, UCLA, Franz Hall 1285, P.O. Box 951563, Los Angeles, CA, 90095-01563, USA

    Hector F. Myers PhD

  2. Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, USA

    Lekeisha A. Sumner PhD, Tamara B. Loeb PhD, Jennifer Vargas Carmona PhD & Gail E. Wyatt PhD

  3. Department of Psychology, California State University, San Bernardino, 5500 University Parkway, San Bernardino, CA, 92407-2396, USA

    Jodie B. Ullman PhD

  4. Department of Psychiatry and Biobehavioral Sciences, UCLA Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Los Angeles, CA, 90024-1759, USA

    Lekeisha A. Sumner PhD, Tamara B. Loeb PhD, Jennifer Vargas Carmona PhD & Gail E. Wyatt PhD

Authors
  1. Hector F. Myers PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lekeisha A. Sumner PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jodie B. Ullman PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tamara B. Loeb PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jennifer Vargas Carmona PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gail E. Wyatt PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hector F. Myers PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Myers, H.F., Sumner, L.A., Ullman, J.B. et al. Trauma and Psychosocial Predictors of Substance Abuse in Women Impacted by HIV/AIDS. J Behav Health Serv Res 36, 233–246 (2009). https://doi.org/10.1007/s11414-008-9134-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11414-008-9134-2

Keywords

Search

Navigation