Does a history of violent offending impact treatment response for comorbid PTSD and substance use disorders? A secondary analysis of a randomized controlled trial

Autor: Ronald A. Nicholson, Teresa Lopez-Castro, Aeriell Armas, Denise A. Hien, Kathryn M. Z. Smith
Rok vydání: 2019
Předmět:
Adult
Male
medicine.medical_specialty
Substance-Related Disorders
Psychological intervention
030508 substance abuse
Medicine (miscellaneous)
Poison control
Comorbidity
Violence
Relapse prevention
behavioral disciplines and activities
Suicide prevention
Article
law.invention
Stress Disorders
Post-Traumatic
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
Outcome Assessment
Health Care
mental disorders
Injury prevention
medicine
Humans
030212 general & internal medicine
Psychiatry
health care economics and organizations
Cognitive Behavioral Therapy
Delivery of Health Care
Integrated
business.industry
Human factors and ergonomics
Criminals
Middle Aged
medicine.disease
humanities
Substance abuse
Psychiatry and Mental health
Clinical Psychology
Diagnosis
Dual (Psychiatry)
Female
Pshychiatric Mental Health
0305 other medical science
business
Zdroj: Journal of Substance Abuse Treatment. 97:47-58
ISSN: 0740-5472
DOI: 10.1016/j.jsat.2018.11.009
Popis: Research has shown that posttraumatic stress disorder (PTSD), substance use disorder (SUD), criminality, and violence are powerfully intertwined. However, little is known about the prevalence of violence perpetration amongst individuals with co-occurring PTSD and SUD (PTSD + SUD) and how such histories impact and interact with varying treatment approaches. The present study examined the rates and effect upon treatment of violent offenses in individuals with PTSD + SUD. We analyzed psychiatric, legal, and demographic data of an ethnically diverse sample (n = 80) recruited from an urban, economically disadvantaged area to participate in a randomized controlled trial of two cognitive behavioral treatments for PTSD + SUD: Concurrent Treatment of PTSD and SUD Using Prolonged Exposure (COPE) and Relapse Prevention (RP). A majority of the sample (61.3%) endorsed a prior arrest history; 27.5% of individuals reported an arrest for a violent crime with men disproportionately represented among those with a violent offending history (60.3% vs.90.9%, p = .008). Two-level mixed effect models revealed an interaction between violent offending, treatment type, and time upon PTSD symptom severity, but not SUD symptom severity. Findings underscore the likelihood of criminal justice involvement among individuals suffering from PTSD + SUD and the relevance of trauma-informed care to justice-involved populations. Treatment which targets PTSD and SUD concurrently, in contrast to SUD-only interventions, may be particularly beneficial for individuals with histories of violence perpetration, suggesting a potential avenue for breaking cycles of victimization and violence.
Databáze: OpenAIRE
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