Complex PTSD and Its Relationship To Mental Health and Substance Abuse Outcomes In A Forensic Sample

Complex trauma has been associated with symptoms of complex posttraumatic stress disorder (C-PTSD), which are often reflected in range of mental health and substance abuse problems.  This study examined a mediation model of complex trauma (i.e., childhood abuse) and risk of problematic substance use in a forensic sample through a secondary analysis.  C-PTSD severity and various mental health outcomes were hypothesized to mediate the relationship between childhood abuse and problematic substance use.  Findings support mediation in some instances, but C-PTSD was found to be more consistently associated with mental health problems than childhood abuse, and substance abuse problems than childhood abuse or mental health problems.  The number of types of traumatic exposure also was associated with both C-PTSD severity and the number of mental health diagnoses, consistent with cumulative trauma perspectives. Thus, it appears that C-PTSD may be a sequela of complex trauma (childhood abuse and multiple subsequent types of trauma) that has a relationship with the complexity of mental health problems, as well as a relationship with substance abuse problems, independent of mental health problems, particularly Axis I diagnoses (including PTSD).  In addition, women were found to have more severe C-PTSD compared to men, but as a result of women having greater exposure to childhood abuse.  Overall, the findings from this study extend support for C-PTSD and its contribution to mental health and substance use problems.