Evidence map›Paper›PMID 39918603›Full record

ArticleSocial psychiatry and psychiatric epidemiology2025

Multi-level socioeconomic modifiers of the comorbidity of post-traumatic stress and tobacco, alcohol, and cannabis use: the importance of income.

Henri M Garrison-Desany, Jacquelyn L Meyers, Sarah D Linnstaedt, Karestan C Koenen, Stacey L House, Francesca L Beaudoin, Xinming An, Thomas C Neylan, Gari D Clifford, Tanja Jovanovic and 23 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Social psychiatry and psychiatric epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

33 authors.

Henri M Garrison-DesanyDepartment of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA. hgarrisondesany@hsph.harvard.edu.
Jacquelyn L MeyersDepartment of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, New York, NY, 11203, USA.
Sarah D LinnstaedtInstitute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA.
Karestan C KoenenDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, 02115, USA.
Stacey L HouseDepartment of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA.
Francesca L BeaudoinDepartment of Epidemiology, Brown University, Providence, RI, 02930, USA.
Xinming AnInstitute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA.
Thomas C NeylanDepartments of Psychiatry and Neurology, University of California San Francisco, San Francisco, CA, 94143, USA.
Gari D CliffordDepartment of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, 30332, USA.
Tanja JovanovicDepartment of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, 48202, USA.
Laura T GermineInstitute for Technology in Psychiatry, McLean Hospital, Belmont, MA, 02478, USA.
Kenneth A BollenDepartment of Psychology and Neuroscience and Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA.
Scott L RauchInstitute for Technology in Psychiatry, McLean Hospital, Belmont, MA, 02478, USA.
John P HaranDepartment of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, 01655, USA.
Alan B StorrowDepartment of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.
Christopher LewandowskiDepartment of Emergency Medicine, Henry Ford Health System, Detroit, MI, 48202, USA.
Paul I MuseyDepartment of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
Phyllis L HendryDepartment of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, 32209, USA.
Sophia SheikhDepartment of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, 32209, USA.
Christopher W JonesDepartment of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, 08103, USA.
Brittany E PunchesDepartment of Emergency Medicine, Ohio State University College of Medicine, Columbus, OH, 43210, USA.
Jose L PascualDepartment of Surgery, Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, 19104, USA.
Mark J SeamonPerelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
Erica HarrisDepartment of Emergency Medicine, Einstein Medical Center, Philadelphia, PA, 19107, USA.
Claire PearsonDepartment of Emergency Medicine, Wayne State University, Ascension St. John Hospital, Detroit, MI, 48202, USA.
David A PeakDepartment of Emergency Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA.
Robert M DomeierDepartment of Emergency Medicine, Trinity Health-Ann Arbor, Ypsilanti, MI, 48197, USA.
Niels K RathlevDepartment of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, 01107, USA.
Brian J O'NeilDepartment of Emergency Medicine, Wayne State University, Detroit Receiving Hospital, Detroit, MI, 48202, USA.
Paulina SergotDepartment of Emergency Medicine, McGovern Medical School at UTHealth, Houston, TX, 77030, USA.
Steven E BruceDepartment of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA.
Samuel A McLeanDepartment of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA.
Christy A DencklaDepartment of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.

Funding

Clinical Features and Neuropathological Basis of Sleep Wake Behavior in Alzheimer's and PSPR01AG060477 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Lea Tenenholz Grinberg, Thomas C Neylan · 2019 to 2026
$8.2M
Extracellular vesicles as biomarkers of trauma exposure and PTSD riskR01MH129495 · NIMH · UNIVERSITY OF COLORADO DENVER · PI Tracy L Bale, Tanja Jovanovic · 2022 to 2026
$4.0M
Mobile Measures of Threat Sensitivity for Cross-sectional and Longitudinal AssessmentR01MH121617 · NIMH · MCLEAN HOSPITAL · PI GERMINE, LAURA THI · 2020 to 2025
$3.9M
Investigating Fear System Myelination in PTSD Using In Vivo and Post Mortem DataR01MH132617 · NIMH · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI HUBER, BERTRAND R, NEYLAN, THOMAS C · 2023 to 2025
$2.1M
NIA NIH HHS R01 AG060477NIMH NIH HHS 5U01MH110925NIMH NIH HHS R01 MH121617NIMH NIH HHS R01 MH129495NIMH NIH HHS R01 MH132617
6 · The paper itself

Abstract

purposePost-traumatic stress (PTS) symptoms are highly comorbid with substance use (i.e., alcohol, tobacco, and cannabis). Few studies have investigated potential individual-, household-, and neighborhood-level socioeconomic effect modifiers of this comorbidity in longitudinal analyses. We aim to examine interactions between this multi-level environment and PTS symptoms on future substance use behaviors.

methodsData were drawn from the Advancing Understanding of RecOvery afteR traumA (AURORA) study, including 2943 individuals who presented to the emergency department (ED) within 72 h of a traumatic event. Frequency of tobacco, alcohol, cannabis use, and PTS symptoms were reported at 6 timepoints. Mixed effect Poisson models, clustered by state, were used to generate incidence rate ratios (IRRs) substance use, both cross-sectionally and prospectively. Moderation analysis of PTS and substance use, stratified by household income and area deprivation index (ADI), was conducted using mixed effect models and parallel process growth curves.

resultsSignificant associations were observed between PTS with tobacco, alcohol, and cannabis use frequency cross-sectionally, and for tobacco and alcohol and PTS exposure prospectively. Lower income (P < 0.001) and higher deprivation (P < 0.001) were associated with tobacco use, while higher income (P < 0.001) and less deprivation (P = 0.01) were associated with increased alcohol use. We found modest modification by household income for alcohol and tobacco, and little evidence of modification by neighborhood ADI.

conclusionsHousehold income had greater evidence of effect modification for substance use, compared to neighborhood-level ADI. Our findings demonstrate that household indicators of socioeconomic status likely modify the relationship between PTS and substance use.

Indexed as

Alcohol DrinkingIncomeMarijuana UseStress Disorders, Post-TraumaticTobacco UseAdultComorbidityCross-Sectional StudiesEmergency Service, HospitalFemaleHumansLongitudinal StudiesMaleMiddle AgedProspective StudiesSocioeconomic FactorsAlcoholHousehold incomeNeighborhoodPost-traumatic stress disorderTobacco

Identifiers

PMID39918603
PMCPMC13033325

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.