Lagged effects of substance use on PTSD severity in a randomized controlled trial with modified prolonged exposure and relapse prevention
| Autor: | Kathryn M. Z. Smith, Denise A. Hien, Santiago Papini, Teresa Lopez-Castro, Lesia M. Ruglass, Max Owens |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 050103 clinical psychology medicine.medical_specialty Substance-Related Disorders medicine.medical_treatment Exposure therapy Implosive Therapy Context (language use) Comorbidity PsycINFO Relapse prevention behavioral disciplines and activities Article law.invention Stress Disorders Post-Traumatic 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Intervention (counseling) Outcome Assessment Health Care mental disorders Secondary Prevention medicine Humans 0501 psychology and cognitive sciences Psychiatry 05 social sciences Middle Aged medicine.disease 030227 psychiatry Substance abuse Psychiatry and Mental health Clinical Psychology Female Psychology |
| Zdroj: | Journal of Consulting and Clinical Psychology. 86:810-819 |
| ISSN: | 1939-2117 0022-006X |
| DOI: | 10.1037/ccp0000345 |
| Popis: | OBJECTIVE To advance understanding of the effectiveness of evidence-based treatments for comorbid posttraumatic stress disorder (PTSD) and substance use disorder (SUD), research must provide a more nuanced picture of how substance use affects change in PTSD symptoms over the course of treatments and whether prolonged exposure techniques can be efficacious during active substance use. A data set that included patients with PTSD/subthreshold-PTSD and SUD treated with an exposure-based intervention provided an opportunity to conduct a secondary analysis to test how patients' substance use impacted PTSD change over treatment. METHOD We applied growth models to week-to-week PTSD symptom and substance use changes during treatment and follow-up of a randomized controlled trial of two cognitive-behavioral treatments for PTSD and SUD: Concurrent Treatment of PTSD and SUD Using Prolonged Exposure (COPE) and Relapse Prevention Therapy (RPT). Cross-lagged analyses were used to determine whether prior week substance use impacted subsequent PTSD symptom severity. RESULTS Both treatments evidenced significant reductions in PTSD symptom severity. In the context of continued substance use, results suggest that individuals still benefit from exposure-based treatment. CONCLUSION Results provide evidence that RPT and COPE both led to significant reductions in PTSD, providing further support that exposure-based techniques tailored for SUD can be conducted without jeopardizing PTSD or SUD outcomes. Implications for clinical decision making around treatment selection are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved). |
| Databáze: | OpenAIRE |
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