The relationship between interpersonal trauma and substance misuse in pregnancy

Trauma is defined by the Diagnostic and Statistical Manual of Mental Disorders (5^th Edition) as exposure to actual or threatened death, serious injury or sexual violence in one or more of four ways (American Psychiatric Association, 2013):

Interpersonal trauma (IPT) is therefore recognised as a result of a variety of experiences including childhood maltreatment, sexual assault, physical assault, intimate partner violence, war, bereavement and crime.

Experiences of trauma are commonplace and remain embedded in global culture and economics, particularly for women and children. The World Health Organization (WHO) (2017) estimates that 1 in 4 adults worldwide have experienced physical abuse as children and many report having experienced neglect and emotional abuse. Exposure to a spectrum of violence may also be common (Finkelhor et al, 2005): 1 in 5 women and 1 in 13 men report surviving childhood sexual abuse (WHO, 2017). Childhood sexual abuse rarely occurs in isolation and is commonly interrelated with other childhood adversities such as physical and emotional abuse (Felitti et al, 1998; Hillis et al, 2000; Prentice, 2002; Guthrie, 2004; Gilson et al, 2008; Lukasse et al, 2009; Leeners et al, 2010; Draucker et al, 2011; Van Der Kolk, 2014).