Trauma experiences are often at the core of co-occurring substance abuse and mental health disorders. Many women report the initiation of substance use after a specific traumatic event. Among women in substance abuse treatment, 55% to 95% have experienced trauma. A sizeable body of literature has shown spirituality to be a mitigating factor in recovery from co-occurring trauma and substance use disorders. Although advancements have been made concerning trauma and spirituality, gaps remain in comprehensive, gender-specific, assessment strategies and treatment models that include an understanding of the impact of trauma on spiritual development.
This exploratory study examined the relationship between trauma and the spiritual well-being of women with substance use disorders. Specifically, this study examined the relationship between type of trauma and the spiritual well-being of women with substance use disorders, the relationship between age of first traumatic occurrence and the spiritual well-being, and the relationship between the number of traumatic occurrences and the spiritual well-being score as measured by Spiritual Well-Being Scale. Data were collected from adult females residents (n = 108) of a two-year modified therapeutic community. Participants met DSM IV criteria for a substance use disorder and reported a lifetime history of at least one traumatic occurrence.
The results of the study reflect descriptive data (demographic and frequency data) and outcome data from the Adapted Trauma Assessment and Spiritual Well-Being Scale. Descriptive data provided a representative profile of the sample. The majority of the women were White/Caucasian and Black/African American women in their late thirties. Most had obtained a high school education or equivalent. The typical participant initiated alcohol use between the age of 13 and 14, and drug use (other than alcohol) around the age of 16. Cocaine was identified as the primary substance used. The majority of the participants reported experiencing eleven traumatic occurrences. Most had experienced their first trauma between 9 and 10 years of age. "Physical Assault" and "Completed Rapes" were the most frequently reported type of trauma occurrence. The mean Spiritual Well-Being Score (94.0) indicated the majority of the participants had a scores within the high level of the "medium" range.
When addressing the research question, "What is the relationship between the type of trauma and spiritual well-being for women with a substance use disorder when comparing different types of trauma?" the data indicates that women who experienced sexual molestation had significantly lower (p = .047) Spiritual Well-Being scores than those who had not experienced the trauma of sexual molestation. For the question, "What is the relationship between age of first traumatic occurrence and spiritual well-being as reflected by the Spiritual Well-Being Scale and the Trauma Assessment?" a significant positive correlation between age of first trauma from "Physical Assault" (r = .178, p = .039), "Being Tormented, Stalked, or Repeatedly Humiliated" (r = .244, p = .048), "Causing Harm" to another person (r = .519, p = .016) and Spiritual Well-Being scores was found. That is, as the age at first occurrence increased so did Spiritual Well-Being scores. Put another way, the younger the participant was at the age of each of these trauma occurrences, the lower her spiritual well-being scores. Examining the question, "What is the relationship between the number of traumatic occurrences and spiritual well-being as measured by the Spiritual Well-Being Scale and the Trauma Assessment?" no significant relationship (r = -.093, p = .336) was found between the total number of traumatic occurrences and Spiritual Well-Being scores of women with substance use disorders.
This study examined the complex and co-occurring clinical concerns of women with substance use disorders. Conceptualized through Fowler's Faith Development Theory, these findings address the implications of trauma and spirituality from a developmental lifespan perspective. Further, prevalence rates for co-occurring trauma and substance abuse identified in this study reinforce the need for comprehensive, gender-specific, trauma-informed, and trauma-specific service delivery systems that recognizes the unique life experiences of women. Recognition of the prevalence of co-occurring trauma and substance use disorders and the impact of those events on treatment presentation, symptomology, retention and completion fosters a more holistic clinical perspective. Integration of spirituality in the provision of care promotes the inclusion of intrinsic and extrinsic supports that provide mitigating factors in trauma recovery.
|Advisor:||Sias, Shari M.|
|Commitee:||Crozier, Mary, Leierer, Stephen, O'Brien, Kevin, Toriello, Paul|
|School:||East Carolina University|
|Department:||Rehabilitation Counseling and Administration|
|School Location:||United States -- North Carolina|
|Source:||DAI-A 75/10(E), Dissertation Abstracts International|
|Subjects:||Womens studies, Public health, Clinical psychology, Spirituality|
|Keywords:||Spiritual well-being, Substance abuse, Trauma, Women|
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