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High‐risk behaviors and drinking‐to‐cope as mediators of lifetime abuse and PTSD symptoms in clients with severe mental illness
Author(s) -
O'Hare Thomas,
Shen Ce,
Sherrer Margaret
Publication year - 2010
Publication title -
journal of traumatic stress
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.259
H-Index - 134
eISSN - 1573-6598
pISSN - 0894-9867
DOI - 10.1002/jts.20515
Subject(s) - psychology , clinical psychology , psychiatry , structural equation modeling , substance abuse , mental illness , mental health , mood , schizophrenia (object oriented programming) , sexual abuse , poison control , injury prevention , medicine , medical emergency , statistics , mathematics
Face‐to‐face interviews with 276 community mental health clients (56.2% women; 42.8% men) diagnosed with schizophrenia spectrum disorders (44.6%) and major mood disorders (55.4%) were used to examine mediating relationships among physical and sexual abuse, high‐risk behaviors, drink‐to‐cope motives, and posttraumatic stress disorder (PTSD) symptom severity. Structural equation modeling revealed that both high‐risk behaviors and drinking‐to‐cope significantly mediated the relationship between lifetime abuse and PTSD symptom severity with an excellent fit of model to data. Alternative models using PTSD symptom level as mediator were also tested, but did not meet optimal goodness‐of‐fit standards. Implications of findings call for vigilant screening for trauma, substance abuse, and high risk behaviors in clients with severe mental illnesses to inform treatment, and the need for longitudinal studies to test causal pathways.