Coping strategy utilization among posttraumatic stress disorder symptom severity and substance use co-occurrence typologies: A latent class analysis

Psychol Trauma. 2021 Nov;13(8):929-939. doi: 10.1037/tra0000964. Epub 2020 Sep 7.

Abstract

Objective: There is a lack of research on primary prevention of posttraumatic stress disorder (PTSD) symptoms and substance use among trauma-exposed populations. To guide the development of more effective prevention efforts, the current study sought to identify underlying coping mechanisms that impact PTSD-substance use co-occurrence.

Method: A person-centered analytic approach (latent class analysis) examined PTSD-substance use co-occurrence typologies (classes) and identified theoretically adaptive (e.g., active coping) and maladaptive (e.g., denial) coping strategies that differentiated between classes among a sample of 1,270 trauma-exposed participants (Mage = 20.71, 73.5% female, 45.7% White).

Results: Latent class analysis identified five distinct typologies, reflective of extant epidemiological and etiological work. Generally, behavioral disengagement and self-blame coping increased the likelihood of being in more severe PTSD-illicit substance use (e.g., cocaine) comorbidity classes. Positive reframing and planning differentiated between low and moderate illicit substance typologies with moderate PTSD severity. Venting, acceptance, and self-distraction differentiated between asymptomatic and moderate PTSD severity typologies with low illicit substance use.

Conclusions: Findings identify general coping strategies associated with increased likelihood of being in more severe comorbidity typologies, as well as several unique coping strategies associated with risk of transitioning between low/moderate PTSD and illicit substance use classes. Relevant interventions (e.g., trauma psychoeducation, guilt-reduction therapy, psychological first aid) that may be targets for future prevention-oriented work are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

MeSH terms

  • Adaptation, Psychological
  • Female
  • Humans
  • Latent Class Analysis
  • Male
  • Psychological First Aid
  • Stress Disorders, Post-Traumatic* / epidemiology
  • Substance-Related Disorders* / epidemiology