Project Details


DESCRIPTION (Adapted from the Investigator's Abstract): For the majority of
inner-city women with crack/cocaine dependence, chronic traumatic
victimizations and their far-reaching psychological consequences are ongoing
obstacles to achieving abstinence in early recovery from drug addiction.
One psychiatric consequence of chronic victimization is developing a
posttraumatic stress disorder (PTSD). Studies have demonstrated that
comorbid psychopathology such as PTSD in female substance abusers is
associated with poorer outcomes, which may include any or all of the
following: (1) poor substance abuse treatment compliance manifested by
ongoing substance abuse, especially cocaine abuse, and high treatment
drop-out rates; (2) chronic psychiatric symptoms including feelings of
terror, and hopelessness, intrusive recollections, hyperarousal, affective
numbing, depression and anxiety, and numerous nonspecific somatic symptoms;
and (3) high-risk sexual behaviors which may lead to HIV infection. While
the need for treatment approaches to address such problems has been
demonstrated empirically, and the clinical literature attests to the
potential of such approaches, to date there are not known controlled studies
which examine the efficacy of manualized treatments with
crack/cocaine-dependent women who are suffering from PTSD.

The proposed study aims to examine the efficacy of an enhanced cocaine
treatment based on relapse prevention (RPT) which includes a specific
manualized component geared towards coping with and reducing PTSD
symptomatology for women with cocaine dependence.

This randomized two-armed clinical trial will assess the relative efficacy
of PTSDRPT versus RPT alone in treating inner- city women with cocaine
dependence and comorbid PTSD over a three month period with repeated
measures at baseline, completion of treatment (3 months), 3-month
post-treatment follow-up and 6 month post-treatment follow-up.
Concurrently, it will also evaluate a non-randomized, non-specific
"treatment-as-usual" TAU) comparison condition. The specific outcomes to be
examined in the present study are efficacy in: 1a) reducing crack/cocaine
use; (1b) maintaining retention rates in cocaine abuse 2) The research aims
to assess the impact of potential predictors (including baseline severity of
cocaine use, PTSD, depression and intensity of other services received) on
cocaine use and PTSD symptomatology over follow-up.

3) The research will also assess the impact of potential mediators,
representing acquisition of intervention components, on cocaine use and PTSD
symptomatology over the three assessment periods, especially examining
concurrent level of PTSDRPT and RPT alone skill and concurrent level of
perceived self-efficacy to use these skills.

The proposed study has the particular advantages of (1) adding the rigorous
assessment of DSM-IV PTSD to the study of inner-city cocaine-dependent
women; and (2) adding a manualized PTSD component to cocaine abuse treatment
for these women, which builds directly on the empirical findings of the
researchers' prior work.
Effective start/end date5/1/9712/31/00


  • National Institute on Drug Abuse
  • National Institute on Drug Abuse
  • National Institute on Drug Abuse
  • National Institute on Drug Abuse


  • Psychiatry and Mental health


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