Childhood trauma and resilience : vulnerabilities to develop crack/cocaine dependence

Abstract

Background: Crack cocaine dependence is a health problem of epidemic proportions and there is lack of evidence concerning vulnerability factors that could lead to crack cocaine use. The aim of this study is to investigate characteristics of resilience in a group of crack cocaine users and its association with childhood trauma and PTSD. Method: This is a case-control study in which we evaluated 218 crack cocaine inpatients users and 215 healthy controls, recruited from the capital city of the southern State of Brazil. Childhood Trauma was evaluated with the Childhood Trauma Questionnaire; resilience was evaluated with the Resilience Scale; and post-traumatic stress disorder (PTSD) was evaluated with the Mini-International Neuropsychiatric Interview. Results: Childhood trauma was significantly higher among crack cocaine users in all trauma domains (p<0.001), except for sexual abuse. Most resilience scores was lower among crack cocaine users (p<0.01). Having higher scores of childhood trauma and lower scores of resilience increase the odds to become a crack cocaine user (p<0.001), despite the diagnosis of PTSD. Discussion: Childhood trauma appears to be a risk factor to become a crack cocaine user while resilience features may be a protection factor. To understand factors of vulnerabilities in this population is important for the development of more efficacious treatment and preventive strategies.