TY - JOUR
T1 - The role of alcohol misuse in PTSD outcomes for women in community treatment
T2 - A secondary analysis of NIDA's Women and Trauma Study
AU - Hien, Denise A.
AU - Campbell, Aimee N.C.
AU - Ruglass, Lesia M.
AU - Hu, Mei Chen
AU - Killeen, Therese
N1 - Funding Information:
Role of funding source: The research reported in this article was supported by a grant from the National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN) : U10 DA13035 (Edward Nunes, PI); the NIDA CTN publication committee reviewed a draft of this publication and provided comments.
PY - 2010/9
Y1 - 2010/9
N2 - Background: Individuals with comorbid substance use and posttraumatic stress disorder may differentially benefit from integrated trauma-focused interventions based on specific presenting characteristics such as substance use type and PTSD severity. The current study is a secondary analysis of a NIDA Clinical Trials Network study exploring the effectiveness of two interventions for women with comorbid PTSD and substance use disorders. Method: Generalized estimating equations were used to examine the association of baseline alcohol misuse with PTSD outcome measures over time for all randomized participants. Results: Women entering treatment with baseline alcohol misuse had higher Post Traumatic Stress Disorder Symptom Scale (PSS-SR) total scores (t=2.43, p<.05), cluster C (avoidance/numbing) scores (t=2.63, p<.01), and cluster D (hyper-arousal) scores (t=2.31, p<.05). For women with alcohol misuse, after treatment week 1, PSS-SR scores were significantly lower in the Seeking Safety intervention during treatment (χ2(1)=4.00, p<.05) and follow-up (χ2(1)=4.87, p<.05) compared to those in the health education intervention. Alcohol misusers in the Seeking Safety group who had higher baseline hyper-arousal severity improved more quickly than those with lower baseline hyper-arousal severity during treatment (χ2(1)=4.06, p<.05). Conclusions: These findings suggest that the type of substance abuse at treatment entry may inform treatment selection, predict treatment response among those with co-occurring PTSD and substance use disorders, and indicate a more severe clinical picture.
AB - Background: Individuals with comorbid substance use and posttraumatic stress disorder may differentially benefit from integrated trauma-focused interventions based on specific presenting characteristics such as substance use type and PTSD severity. The current study is a secondary analysis of a NIDA Clinical Trials Network study exploring the effectiveness of two interventions for women with comorbid PTSD and substance use disorders. Method: Generalized estimating equations were used to examine the association of baseline alcohol misuse with PTSD outcome measures over time for all randomized participants. Results: Women entering treatment with baseline alcohol misuse had higher Post Traumatic Stress Disorder Symptom Scale (PSS-SR) total scores (t=2.43, p<.05), cluster C (avoidance/numbing) scores (t=2.63, p<.01), and cluster D (hyper-arousal) scores (t=2.31, p<.05). For women with alcohol misuse, after treatment week 1, PSS-SR scores were significantly lower in the Seeking Safety intervention during treatment (χ2(1)=4.00, p<.05) and follow-up (χ2(1)=4.87, p<.05) compared to those in the health education intervention. Alcohol misusers in the Seeking Safety group who had higher baseline hyper-arousal severity improved more quickly than those with lower baseline hyper-arousal severity during treatment (χ2(1)=4.06, p<.05). Conclusions: These findings suggest that the type of substance abuse at treatment entry may inform treatment selection, predict treatment response among those with co-occurring PTSD and substance use disorders, and indicate a more severe clinical picture.
KW - Alcohol misuse
KW - Cognitive-behavioral therapy
KW - Comorbidity
KW - Posttraumatic stress
KW - Substance abuse
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U2 - 10.1016/j.drugalcdep.2010.04.011
DO - 10.1016/j.drugalcdep.2010.04.011
M3 - Article
C2 - 20537811
AN - SCOPUS:77956185604
SN - 0376-8716
VL - 111
SP - 114
EP - 119
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
IS - 1-2
ER -