Effect of Childhood Trauma on Substance Users’ Attitudes of Coping with Stress
Year 2023,
Volume: 24 Issue: 3, 305 - 315, 30.09.2023
Oya Sevcan Orak
,
Halil İbrahim Bilkay
,
Çiğdem Zengin
Abstract
Objective: This study seeks to examine the effects of childhood traumas on substance users’ attitudes of coping with stress.
Method: This descriptive study seeking relationship was conducted with 133 individuals diagnosed with substance use and receiving treatment in the alcohol and substance treatment centre and closed psychiatry clinics of a mental health hospital located in Turkey.
Results: The mean age of first substance use of the participants included in the study was 17.8 ± 4.7. The participants got the highest score from the emotional neglect subscale of the Childhood Trauma Questionnaire (12.83 ± 3.46). Individuals in the study got the highest score from the religious coping subscale of the Coping Orientation to Problems Experienced Inventory (13.39 ± 2.71). Childhood traumatic experiences were found to be effective in the development of coping attitudes including denial, behavioural disengagement, use of emotional social support, substance use, and acceptance.
Conclusion: Childhood traumatic experiences of substance users have an effect on their dysfunctional coping attitudes. It is recommended that psychiatric nurses include primary, secondary, and tertiary protective approaches towards childhood traumas in their work on combating addiction.
References
- 1. Çavmak Ş, Söyler S. Health education and the fight against addiction in the context of primary health care. Iksad Publications, Ankara. ISBN: 978-625-7897-98-3
- 2. UNODC: United Nations Office on Drugs and Crime. World Drug Report. United Nations, New York, 2018.
- 3. Walters KS, Bulmer SM, Troiano PF, et al. Substance use, anxiety, and depressive symptoms among college students. J Child Adolesc Subst Abuse 2018; 27(2):103-111. https://doi.org/10.1080/1067828X.2017.1420507
- 4. Castellanos-Ryan N, Patricia C. Cognitive risk factors for alcohol and substance addictions. Cognition and Addiction Academic Press 2020; 91-102. https://doi.org/10.1016/B978-0-12-815298-0.00007-1
- 5. Compas BE, Connor-Smith JK, Saltzman H, et al. Coping with stress during childhood and adolescence: problems, progress, and potential in theory and research. Psychol Bull 2001;127(1):87-127. https://doi.org/10.1037/0033-2909.127.1.87.
- 6. Kochan K, Ilhan T. Examining of the attachment style to parents, depression levels, and stress management styles of private soldiers in terms of substance abuse. Addicta: The Turkish Journal on Addictions 2015; 2 (2): 61-109 https://doi.org/10.15805/addicta.2015.2.2.070
- 7. Pedersen ER, Tucker JS, Davis JP,et al. Tobacco/nicotine and marijuana co-use motives in young adults: Associations with substance use behaviors one year later. Psychol Addict Behav 2021;35(2):133-147. https://doi.org/10.1037/adb0000638
- 8. Caparrós B, Masferrer L. Coping strategies and complicated grief in a substance use disorder sample. Front Psychol 2021;11:624065. https://doi.org/10.3389/fpsyg.2020.624065
- 9. Hogarth L, Martin L, Seedat S. Relationship between childhood abuse and substance misuse problems is mediated by substance use coping motives, in school attending South African adolescents. Drug Alcohol Depend 2019;194:69-74.
https://doi.org/10.1016/j.drugalcdep.2018.10.009
- 10. Cicchetti D, Handley ED. Child maltreatment and the development of substance use and disorder. Neurobiol Stress 2019; 10:100144 https://doi.org/10.1016/j.ynstr.2018.100144
- 11. Wang DS, Chung CH, Chang HA, et al. Association between child abuse exposure and the risk of psychiatric disorders: A nationwide cohort study in Taiwan. Child Abuse Negl 2020;101:104362. https://doi.org/10.1016/j.chiabu.2020.104362
- 12. Pasian MS, Benitez P, Lacharité C. Child neglect and poverty: A Brazilian study. Child Youth Serv Rev 2020; 108, 104655. https://doi.org/10.1016/j.childyouth.2019.104655
13. Featherstone B, Morris K, Daniel B, et al. Poverty, inequality, child abuse and neglect: Changing the conversation across the UK in child protection? Child. Youth Serv. Rev. 2019; 97: 127-133. https://doi.org/10.1016/j.childyouth.2017.06.009
- 14. Vanderminden J, Hamby S, David-Ferdon C, et al. Rates of neglect in a national sample: Child and family characteristics and psychological impact. Child Abuse Negl 2019; 88: 256-265. https://doi.org/10.1016/j.chiabu.2018.11.014
- 15. McLeigh JD, McDonell JR, Lavenda O. Neighborhood poverty and child abuse and neglect: The mediating role of social cohesion. Child Youth Serv Rev 2018; 93: 154-160. https://doi.org/10.1016/j.childyouth.2018.07.018
- 16. Azar ST, McGuier DJ, Miller EA, et al. Child neglect and maternal cross-relational social cognitive and neurocognitive disturbances. J Fam Psychol 2017;31(1):8-18. https://psycnet.apa.org/doi/10.1037/fam0000268
- 17. Raby KL, Roisman GI, Labella MH, et al. The legacy of early abuse and neglect for social and academic competence from childhood to adulthood. Child Dev 2019; 90(5):1684-1701. https://doi.org/10.1111/cdev.13033
- 18. Blanco L, Nydegger LA, Camarillo G, et al. Neurological changes in brain structure and functions among individuals with a history of childhood sexual abuse: A review. Neurosci Biobehav Rev 2015; 57:63-9. https://doi.org/10.1016/j.neubiorev.2015.07.013
- 19. Garami J, Valikhani A, Parkes D, et al. Examining perceived stress, childhood trauma and interpersonal trauma in individuals with drug addiction. Psychol Rep 2019;122(2):433-450https://doi.org/10.1177/0033294118764918
- 20. Syed SA, Cranshaw M, Nemeroff CB. Child abuse and neglect: stress responsivity and resilience. Stress Resilience Academic Press 2020; 181-196. https://doi.org/10.1016/B978-0-12-813983-7.00013-6
- 21. Gruhn MA, Compas BE. Effects of maltreatment on coping and emotion regulation in childhood and adolescence: A meta-analytic review. Child Abuse Negl 2020; 103:104446 https://doi.org/10.1016/j.chiabu.2020.104446
- 22. Bernstein DP, Stein JA, Newcomb MD, et al. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl 2003; 27(2):169-90. https://doi.org/10.1016/S0145-2134(02)00541-0
- 23. Kaya S. The adaptation of the brief screening version of childhood trauma questionnaire into Turkish. Master Thesis, Muğla Sıtkı Koçman University, Department of Educational Sciences, Muğla; 2014
- 24. Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: a theoretically based approach. J Pers Soc Psychol 1989;56(2):267-83. https://psycnet.apa.org/doi/10.1037/0022-3514.56.2.267
- 25. Ağargün MY, Beşiroğlu L, Kıran ÜK, et al.The psychometric properties of the COPE inventory in Turkish sample: a preliminary research. Anadolu Psikiyatri Derg 2005; 6:221-226.
- 26. Proctor LJ, Lewis T, Roesch S, et al. Child maltreatment and age of alcohol and marijuana initiation in high-risk youth. Addict Behav 2017;75:64-69. https://doi.org/10.1016/j.addbeh.2017.06.021
- 27. Evans EA, Goff SL, Upchurch DM, et al. Childhood adversity and mental health comorbidity in men and women with opioid use disorders. Addict Behav 2020;102:106149. https://doi.org/10.1016/j.addbeh.2019.106149
- 28. Fung HW, Chung HM, Ross CA. Demographic and mental health correlates of childhood emotional abuse and neglect in a Hong Kong sample. Child Abuse Negl 2020; 99:104288. https://doi.org/10.1016/j.chiabu.2019.104288
- 29. Moustafa AA, Parkes D, Fitzgerald L, et al. The relationship between childhood trauma, early-life stress, and alcohol and drug use, abuse, and addiction: An integrative review. Curr Psychol 2021; 40(2): 579-584. https://doi.org/10.1007/s12144-018-9973-9
- 30. Halpern SC, Schuch FB, Scherer JN, et al. Child maltreatment and illicit substance abuse: A systematic review and meta‐analysis of longitudinal studies. Child Abus Rev 2018; 27(5): 344-360. https://doi.org/10.1002/car.2534
- 31. Clemens V, Berthold O, Witt A, et al. Lifespan risks of growing up in a family with mental illness or substance abuse. Sci Rep 2020;10(1):15453. https://doi.org/10.1038/s41598-020-72064-w
- 32. McHugh RK, Votaw VR, Sugarman DE, et al. Sex and gender differences in substance use disorders. Clin Psychol Rev 2018; 66:12-23. https://doi.org/10.1016/j.cpr.2017.10.012
- 33. Medlock MM, Rosmarin DH, Connery HS, et al. Religious coping in patients with severe substance use disorders receiving acute inpatient detoxification. Am J Addict 2017; 26(7):744-750. https://doi.org/10.1111/ajad.12606
- 34. Adams J, Mrug S, Knight DC. Characteristics of child physical and sexual abuse as predictors of psychopathology. Child Abuse Negl 2018; 86:167-177. https://10.1016/j.chiabu.2018.09.019.
- 35. VanMeter F, Handley ED, Cicchetti D. The role of coping strategies in the pathway between child maltreatment and internalizing and externalizing behaviors. Child Abuse Negl 2020; 101:104323 https://doi.org/10.1016/j.chiabu.2019.104323
- 36. Danese A, Widom CS. Objective and subjective experiences of child maltreatment and their relationships with psychopathology. Nat Hum Behav 2020; 4(8):811-818. https://doi.org/10.1038/s41562-020-0880-3
- 37. Schmeck K. Long-term consequences of early neglect and abuse. Psychiatr Danub 2020; 32(3):343-345.
- 38. Lippard ETC, Nemeroff CB. The devastating clinical consequences of child abuse and neglect: increased disease vulnerability and poor treatment response in mood disorders. Am J Psychiatry 2020;177(1):20-36. https://doi.org/10.1176/appi.ajp.2019.19010020
- 39. Zhang S, Lin X, Liu J, et al. Prevalence of childhood trauma measured by the short form of the Childhood Trauma Questionnaire in people with substance use disorder: A meta-analysis. Psychiatry Res 2020;294:113524. https://doi.org/10.1016/j.psychres.2020.113524
- 40. VanMeter F, Nivison MD, Englund MM, et al. Childhood abuse and neglect and self-reported symptoms of psychopathology through midlife. Dev Psychol 2021; 57(5):824-836. https://psycnet.apa.org/doi/10.1037/dev0001169
- 41. Georgsdottir MT, Sigurdardottir S, Gunnthorsdottir H. This is the result of something else: experiences of men that abused drugs and had experienced childhood trauma. Am J Mens Health 2021;15(2):15579883211009348.
https://doi.org/10.1177/15579883211009348
- 42. Brammer WA, Conn BM, Iverson E, et al. Coping motives mediate the association of trauma history with problematic cannabis use in young adult medical cannabis patients and non-patient cannabis users. Subst Use Misuse 2022;57(5):684-697. https://doi.org/10.1080/10826084.2022.2026970
- 43. Love HA, Torgerson CN. Traumatic experiences in childhood and adult substance use in a nonclinical sample: the mediating role of arousal/reactivity. J Marital Fam Ther 2019;45(3):508-520. https://doi.org/10.1111/jmft.12348
- 44. Kozak K, Lucatch AM, Lowe DJE, et al. The neurobiology of impulsivity and substance use disorders: implications for treatment. Ann N Y Acad Sci 2019;1451(1):71-91. https://doi.org/10.1111/nyas.13977
- 45. Downey C, Aoife C. The impact of childhood trauma on children's wellbeing and adult behavior. Eur J Trauma Dissoc 2022;6:1:100237. https://doi.org/10.1016/j.ejtd.2021.100237
- 46. Sheffler JL, Piazza JR, Quinn JM, et al. Adverse childhood experiences and coping strategies: identifying pathways to resiliency in adulthood. Anxiety Stress Coping 2019; 32(5):594-609. https://doi.org/10.1080/10615806.2019.1638699
- 47. Gül A, Gül H, Erberk Özen N, et al. Differences between childhood traumatic experiences and coping styles for male and female patients with major depression. Turk Psikiyatri Derg 2017;28(4):246-254. https://doi.org/10.5080/u18193
- 48. Ullman SE, Peter-Hagene L. social reactions to sexual assault disclosure, coping, perceived control and PTSD symptoms in sexual assault victims. J Community Psychol 2014; 42(4):495-508. https://doi.org/10.1002/jcop.21624
Madde Kullanıcılarının Stresle Başa Çıkma Tutumlarında Çocukluk Travmalarının Etkisi
Year 2023,
Volume: 24 Issue: 3, 305 - 315, 30.09.2023
Oya Sevcan Orak
,
Halil İbrahim Bilkay
,
Çiğdem Zengin
Abstract
Amaç: Bu çalışma, çocukluk çağı travmalarının madde kullanıcılarının stresle başa çıkma tutumları üzerindeki etkilerini incelemeyi amaçlamaktadır.
Yöntem: İlişki arayan tanımlayıcı tipteki bu araştırma, Türkiye'de bulunan bir ruh sağlığı hastanesinin alkol ve madde tedavi merkezi ve kapalı psikiyatri kliniklerinde madde kullanımı tanısı alan ve tedavi gören 133 kişi ile yürütülmüştür.
Bulgular: Araştırmaya dahil edilen katılımcıların ilk madde kullanım yaş ortalamasının 17.8 ± 4.7 olduğu belirlenmiştir. Katılımcıların Çocukluk Dönemi Örselenme Yaşantıları Ölçeği’nden en yüksek puanı duygusal ihmal alt ölçeğinden aldığı saptanmıştır (12.83 ± 3.46). Araştırmadaki bireylerin Başa Çıkma Tutumları Değerlendirme Ölçeği’nin dini başa alt ölçeğinden en yüksek puanı aldıkları belirlenmiştir (13.39 ± 2.71). Çocukluk çağı travmatik yaşantılarının inkar, davranışsal olarak geri çekilme, duygusal sosyal destek kullanımı, madde kullanımı ve kabullenme gibi başa çıkma tutumlarının gelişiminde etkili olduğu bulundu.
Sonuç: Madde kullanıcılarının çocukluk çağı travmatik yaşantıları, onların işlevsel olmayan başa çıkma tutumları üzerinde etkilidir. Psikiyatri hemşirelerinin bağımlılıkla mücadele çalışmalarında çocukluk çağı travmalarına yönelik birincil, ikincil ve üçüncül koruyucu yaklaşımlara yer vermeleri önerilmektedir.
References
- 1. Çavmak Ş, Söyler S. Health education and the fight against addiction in the context of primary health care. Iksad Publications, Ankara. ISBN: 978-625-7897-98-3
- 2. UNODC: United Nations Office on Drugs and Crime. World Drug Report. United Nations, New York, 2018.
- 3. Walters KS, Bulmer SM, Troiano PF, et al. Substance use, anxiety, and depressive symptoms among college students. J Child Adolesc Subst Abuse 2018; 27(2):103-111. https://doi.org/10.1080/1067828X.2017.1420507
- 4. Castellanos-Ryan N, Patricia C. Cognitive risk factors for alcohol and substance addictions. Cognition and Addiction Academic Press 2020; 91-102. https://doi.org/10.1016/B978-0-12-815298-0.00007-1
- 5. Compas BE, Connor-Smith JK, Saltzman H, et al. Coping with stress during childhood and adolescence: problems, progress, and potential in theory and research. Psychol Bull 2001;127(1):87-127. https://doi.org/10.1037/0033-2909.127.1.87.
- 6. Kochan K, Ilhan T. Examining of the attachment style to parents, depression levels, and stress management styles of private soldiers in terms of substance abuse. Addicta: The Turkish Journal on Addictions 2015; 2 (2): 61-109 https://doi.org/10.15805/addicta.2015.2.2.070
- 7. Pedersen ER, Tucker JS, Davis JP,et al. Tobacco/nicotine and marijuana co-use motives in young adults: Associations with substance use behaviors one year later. Psychol Addict Behav 2021;35(2):133-147. https://doi.org/10.1037/adb0000638
- 8. Caparrós B, Masferrer L. Coping strategies and complicated grief in a substance use disorder sample. Front Psychol 2021;11:624065. https://doi.org/10.3389/fpsyg.2020.624065
- 9. Hogarth L, Martin L, Seedat S. Relationship between childhood abuse and substance misuse problems is mediated by substance use coping motives, in school attending South African adolescents. Drug Alcohol Depend 2019;194:69-74.
https://doi.org/10.1016/j.drugalcdep.2018.10.009
- 10. Cicchetti D, Handley ED. Child maltreatment and the development of substance use and disorder. Neurobiol Stress 2019; 10:100144 https://doi.org/10.1016/j.ynstr.2018.100144
- 11. Wang DS, Chung CH, Chang HA, et al. Association between child abuse exposure and the risk of psychiatric disorders: A nationwide cohort study in Taiwan. Child Abuse Negl 2020;101:104362. https://doi.org/10.1016/j.chiabu.2020.104362
- 12. Pasian MS, Benitez P, Lacharité C. Child neglect and poverty: A Brazilian study. Child Youth Serv Rev 2020; 108, 104655. https://doi.org/10.1016/j.childyouth.2019.104655
13. Featherstone B, Morris K, Daniel B, et al. Poverty, inequality, child abuse and neglect: Changing the conversation across the UK in child protection? Child. Youth Serv. Rev. 2019; 97: 127-133. https://doi.org/10.1016/j.childyouth.2017.06.009
- 14. Vanderminden J, Hamby S, David-Ferdon C, et al. Rates of neglect in a national sample: Child and family characteristics and psychological impact. Child Abuse Negl 2019; 88: 256-265. https://doi.org/10.1016/j.chiabu.2018.11.014
- 15. McLeigh JD, McDonell JR, Lavenda O. Neighborhood poverty and child abuse and neglect: The mediating role of social cohesion. Child Youth Serv Rev 2018; 93: 154-160. https://doi.org/10.1016/j.childyouth.2018.07.018
- 16. Azar ST, McGuier DJ, Miller EA, et al. Child neglect and maternal cross-relational social cognitive and neurocognitive disturbances. J Fam Psychol 2017;31(1):8-18. https://psycnet.apa.org/doi/10.1037/fam0000268
- 17. Raby KL, Roisman GI, Labella MH, et al. The legacy of early abuse and neglect for social and academic competence from childhood to adulthood. Child Dev 2019; 90(5):1684-1701. https://doi.org/10.1111/cdev.13033
- 18. Blanco L, Nydegger LA, Camarillo G, et al. Neurological changes in brain structure and functions among individuals with a history of childhood sexual abuse: A review. Neurosci Biobehav Rev 2015; 57:63-9. https://doi.org/10.1016/j.neubiorev.2015.07.013
- 19. Garami J, Valikhani A, Parkes D, et al. Examining perceived stress, childhood trauma and interpersonal trauma in individuals with drug addiction. Psychol Rep 2019;122(2):433-450https://doi.org/10.1177/0033294118764918
- 20. Syed SA, Cranshaw M, Nemeroff CB. Child abuse and neglect: stress responsivity and resilience. Stress Resilience Academic Press 2020; 181-196. https://doi.org/10.1016/B978-0-12-813983-7.00013-6
- 21. Gruhn MA, Compas BE. Effects of maltreatment on coping and emotion regulation in childhood and adolescence: A meta-analytic review. Child Abuse Negl 2020; 103:104446 https://doi.org/10.1016/j.chiabu.2020.104446
- 22. Bernstein DP, Stein JA, Newcomb MD, et al. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl 2003; 27(2):169-90. https://doi.org/10.1016/S0145-2134(02)00541-0
- 23. Kaya S. The adaptation of the brief screening version of childhood trauma questionnaire into Turkish. Master Thesis, Muğla Sıtkı Koçman University, Department of Educational Sciences, Muğla; 2014
- 24. Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: a theoretically based approach. J Pers Soc Psychol 1989;56(2):267-83. https://psycnet.apa.org/doi/10.1037/0022-3514.56.2.267
- 25. Ağargün MY, Beşiroğlu L, Kıran ÜK, et al.The psychometric properties of the COPE inventory in Turkish sample: a preliminary research. Anadolu Psikiyatri Derg 2005; 6:221-226.
- 26. Proctor LJ, Lewis T, Roesch S, et al. Child maltreatment and age of alcohol and marijuana initiation in high-risk youth. Addict Behav 2017;75:64-69. https://doi.org/10.1016/j.addbeh.2017.06.021
- 27. Evans EA, Goff SL, Upchurch DM, et al. Childhood adversity and mental health comorbidity in men and women with opioid use disorders. Addict Behav 2020;102:106149. https://doi.org/10.1016/j.addbeh.2019.106149
- 28. Fung HW, Chung HM, Ross CA. Demographic and mental health correlates of childhood emotional abuse and neglect in a Hong Kong sample. Child Abuse Negl 2020; 99:104288. https://doi.org/10.1016/j.chiabu.2019.104288
- 29. Moustafa AA, Parkes D, Fitzgerald L, et al. The relationship between childhood trauma, early-life stress, and alcohol and drug use, abuse, and addiction: An integrative review. Curr Psychol 2021; 40(2): 579-584. https://doi.org/10.1007/s12144-018-9973-9
- 30. Halpern SC, Schuch FB, Scherer JN, et al. Child maltreatment and illicit substance abuse: A systematic review and meta‐analysis of longitudinal studies. Child Abus Rev 2018; 27(5): 344-360. https://doi.org/10.1002/car.2534
- 31. Clemens V, Berthold O, Witt A, et al. Lifespan risks of growing up in a family with mental illness or substance abuse. Sci Rep 2020;10(1):15453. https://doi.org/10.1038/s41598-020-72064-w
- 32. McHugh RK, Votaw VR, Sugarman DE, et al. Sex and gender differences in substance use disorders. Clin Psychol Rev 2018; 66:12-23. https://doi.org/10.1016/j.cpr.2017.10.012
- 33. Medlock MM, Rosmarin DH, Connery HS, et al. Religious coping in patients with severe substance use disorders receiving acute inpatient detoxification. Am J Addict 2017; 26(7):744-750. https://doi.org/10.1111/ajad.12606
- 34. Adams J, Mrug S, Knight DC. Characteristics of child physical and sexual abuse as predictors of psychopathology. Child Abuse Negl 2018; 86:167-177. https://10.1016/j.chiabu.2018.09.019.
- 35. VanMeter F, Handley ED, Cicchetti D. The role of coping strategies in the pathway between child maltreatment and internalizing and externalizing behaviors. Child Abuse Negl 2020; 101:104323 https://doi.org/10.1016/j.chiabu.2019.104323
- 36. Danese A, Widom CS. Objective and subjective experiences of child maltreatment and their relationships with psychopathology. Nat Hum Behav 2020; 4(8):811-818. https://doi.org/10.1038/s41562-020-0880-3
- 37. Schmeck K. Long-term consequences of early neglect and abuse. Psychiatr Danub 2020; 32(3):343-345.
- 38. Lippard ETC, Nemeroff CB. The devastating clinical consequences of child abuse and neglect: increased disease vulnerability and poor treatment response in mood disorders. Am J Psychiatry 2020;177(1):20-36. https://doi.org/10.1176/appi.ajp.2019.19010020
- 39. Zhang S, Lin X, Liu J, et al. Prevalence of childhood trauma measured by the short form of the Childhood Trauma Questionnaire in people with substance use disorder: A meta-analysis. Psychiatry Res 2020;294:113524. https://doi.org/10.1016/j.psychres.2020.113524
- 40. VanMeter F, Nivison MD, Englund MM, et al. Childhood abuse and neglect and self-reported symptoms of psychopathology through midlife. Dev Psychol 2021; 57(5):824-836. https://psycnet.apa.org/doi/10.1037/dev0001169
- 41. Georgsdottir MT, Sigurdardottir S, Gunnthorsdottir H. This is the result of something else: experiences of men that abused drugs and had experienced childhood trauma. Am J Mens Health 2021;15(2):15579883211009348.
https://doi.org/10.1177/15579883211009348
- 42. Brammer WA, Conn BM, Iverson E, et al. Coping motives mediate the association of trauma history with problematic cannabis use in young adult medical cannabis patients and non-patient cannabis users. Subst Use Misuse 2022;57(5):684-697. https://doi.org/10.1080/10826084.2022.2026970
- 43. Love HA, Torgerson CN. Traumatic experiences in childhood and adult substance use in a nonclinical sample: the mediating role of arousal/reactivity. J Marital Fam Ther 2019;45(3):508-520. https://doi.org/10.1111/jmft.12348
- 44. Kozak K, Lucatch AM, Lowe DJE, et al. The neurobiology of impulsivity and substance use disorders: implications for treatment. Ann N Y Acad Sci 2019;1451(1):71-91. https://doi.org/10.1111/nyas.13977
- 45. Downey C, Aoife C. The impact of childhood trauma on children's wellbeing and adult behavior. Eur J Trauma Dissoc 2022;6:1:100237. https://doi.org/10.1016/j.ejtd.2021.100237
- 46. Sheffler JL, Piazza JR, Quinn JM, et al. Adverse childhood experiences and coping strategies: identifying pathways to resiliency in adulthood. Anxiety Stress Coping 2019; 32(5):594-609. https://doi.org/10.1080/10615806.2019.1638699
- 47. Gül A, Gül H, Erberk Özen N, et al. Differences between childhood traumatic experiences and coping styles for male and female patients with major depression. Turk Psikiyatri Derg 2017;28(4):246-254. https://doi.org/10.5080/u18193
- 48. Ullman SE, Peter-Hagene L. social reactions to sexual assault disclosure, coping, perceived control and PTSD symptoms in sexual assault victims. J Community Psychol 2014; 42(4):495-508. https://doi.org/10.1002/jcop.21624