Lukas A. Basedow is a PhD student at TU Dresden, Germany investigating the co-occurrence of PTSD and SUDs in adolescents. He studied Psychology (B.Sc.) and Neuropsychology (M.Sc.) in the Netherlands, Wellington. New Zealand and Berlin, Germany. His research deals with the role specific substances play for adolescent SUD patients with PTSD, especially focusing on the topic of self-medication. Additionally, Lukas is interested in and works on harm-reduction initiatives, psychedelic substances, and cognitive consequences of substance use.
Coping motives mediate the relationship between PTSD and MDMA use frequency in German adolescents with substance use disorders
Aims: Post-traumatic stress disorder (PTSD) and substance use disorders (SUDs) often co-occur in adolescent SUD patients. Previous research has shown that these patients differ from SUD patients without PTSD in terms of their substance use. In this study, we aimed to test whether the PTSD-use association is mediated by the use motive ‘coping’.
Methods: ‘N’ = 111 (43 % female) adolescent SUD patients, aged 13-18 years, completed questionnaires on use motives and PTSD-related experiences, and underwent a standardized psychiatric interview. Participants were subsequently classified as no traumatic events experienced (‘noTE’ but SUD), experienced traumatic events but no current PTSD diagnosis (‘TE’ with SUD), and having a traumatic event as well as a PTSD (‘PTSD’ with SUD).
Results: The past-year frequency of methylenedioxymethamphetamine (MDMA) use was highest in the PTSD group and lowest in the noTE group (‘H’ (2) = 7.2, ‘p ‘= .027, ‘η2’ = .058). While controlling for sex, the three groups showed similar differences for coping scores (‘F’ (103) = 5.77, ‘p ‘= .004, ‘η2’ = .101). Finally, mediation analyses revealed a mediation (‘b ‘= 0.61, 95% CI [0.29, 1.58], ‘p’ = .145) for the association between group membership and MDMA use frequency.
Conclusions: In SUD patients, we found an association of current PTSD and lifetime traumatic events with higher MDMA use that could be partially explained by self-reported coping motives. This indicates a self-medication process involved specifically in MDMA use compared to the use of other psychoactive substances, possibly due to unique psychoactive effects of MDMA.