☆ 4.5 Article

Concurrent Treatment with Prolonged Exposure for Co-Occurring Full or Subthreshold Posttraumatic Stress Disorder and Substance Use Disorders: A Randomized Clinical Trial

PSYCHOTHERAPY AND PSYCHOSOMATICS (2017)

Journal

PSYCHOTHERAPY AND PSYCHOSOMATICS

Volume 86, Issue 3, Pages 150-161

Publisher

KARGER

DOI: 10.1159/000462977

Keywords

Posttraumatic stress disorder; Substance use disorder; Comorbidity; Integrated treatment; Randomized clinical trial

Funding

National Institute on Drug Abuse [R01DA10843]
NATIONAL INSTITUTE ON DRUG ABUSE [R01DA023187] Funding Source: NIH RePORTER

Ask authors/readers for more resources

Protocol

Community support

Reagent

Community support

Abstract

Background: To test whether an integrated prolonged exposure (PE) approach could address posttraumatic stress disorder (PTSD) symptoms effectively in individuals with co-occurring substance use disorders (SUD), we compared concurrent treatment of PTSD and SUD using PE (COPE) to relapse prevention therapy (RPT) for SUD and an active monitoring control group (AMCG). Methods: We conducted a randomized 12-week trial with participants (n = 110; 64% males; 59% African Americans) who met Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision criteria for full or subthreshold PTSD and SUD. Participants were randomly assigned to COPE (n = 39), RPT (n = 43), or AMCG (n = 28). Results: At the end-of-treatment, COPE and RPT demonstrated greater reduction in PTSD symptom severity relative to AMCG (COPE-AMCG = -34.06, p < 0.001; RPT-AMCG = -22.58, p = 0.002). Although the difference between COPE and RPT was not significant in the complete sample, the subset of participants with full (vs. subthreshold) PTSD demonstrated significantly greater reduction of PTSD severity in COPE relative to RPT. Both treatments were superior to AMCG in reducing the days of primary substance use (COPE-AMCG = -0.97, p = 0.01; RPT-AMCG = -2.07, p < 0.001). Relative to COPE, RPT showed significantly more improvement in SUD outcome at end-of-treatment (RPT-COPE = -1.10, p = 0.047). At 3-month follow-up, COPE and RPT maintained their treatment gains and were not significantly different in PTSD severity or days of primary substance use. Conclusion: COPE and RPT reduced PTSD and SUD severity in participants with PTSD + SUD. Findings suggest that among those with full PTSD, COPE improves PTSD symptoms more than a SUD-only treatment. The use of PE for PTSD was associated with significant decreases in PTSD symptoms without worsening of substance use. (C) 2017 S. Karger AG, Basel

Authors

I am an author on this paper

Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.5

Not enough ratings

Secondary Ratings

Novelty

Significance

Scientific rigor

Rate this paper

Psychosocial functioning in integrated treatment of co-occurring posttraumatic stress disorder and alcohol use disorder

Robert Lyons, Kaitlyn E. Panza, Jonathan Helm, Abigail C. Angkaw, Elizabeth Straus, Sonya B. Norman

Summary: Research suggests that psychosocial functioning improves significantly in treatments for PTSD/AUD, especially with reductions in PTSD severity. However, these improvements do not necessarily lead to clinically meaningful improvements in patients' abilities to navigate important roles.

JOURNAL OF PSYCHIATRIC RESEARCH (2021)