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Rates and Symptoms of PTSD among Cocaine- Dependent Patients

Lisa M. Najavits, Ragna Runkel, Christina Neuner, Arlene F. Frank, Michael E. Thase, Paul Crits-Christoph, Jack Blaine

Objective: This study evaluated lifetime traumatic events and current posttraumatic stress disorder (PTSD) symptoms in a substance abuse sample. Method: Participants in the study consisted of 558 (75.1% male) cocaine-dependent individuals who completed self-report measures of trauma and PTSD symptoms prior to entry into treatment. Results: Results showed a high number of lifetime traumatic events, even among those without PTSD. General disaster was the most prevalent. Current PTSD was found in 10.9% of the participants, with a significantly higher rate among women (21.6%) than among men (7.2%). For those with PTSD, the most prominent PTSD symptom cluster was arousal, and the most common symptoms were restricted affect, detachment and irritability. Participants with PTSD endorsed a large number of symptoms, almost double that needed to meet diagnostic criteria; however, neither number of traumas nor type of trauma was associated with their level of PTSD symptoms. Even among those not meeting PTSD criteria, subthreshold symptoms were found, with avoidance the most prominent cluster. Sociodemographic and recent cocaine use variables did not differentiate the PTSD from non-PTSD groups. Conclusions: PTSD is present in a sizeable percentage of cocaine-dependent treatment- seeking patients, particularly women. Clinicians might address arousal symptoms in particular, which were the most prominent symptom cluster, and which may be exacerbated by cocaine use. Even among those without PTSD, lifetime trauma is substantial and subthreshold PTSD symptoms are common. Vulnerability to PTSD needs further study, as sociodemographic and cocaine use variables did not distinguish between PTSD and non-PTSD groups. (J. Stud. Alcohol 64: 601-606, 2003)