The role of alcohol misuse in PTSD outcomes for women in community treatment: A secondary analysis of NIDA's Women and Trauma Study

Denise A. Hien, Aimee N.C. Campbell, Lesia M. Ruglass, Mei Chen Hu, Therese Killeen

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)114-119
Number of pages6
JournalDrug and Alcohol Dependence
Issue number1-2
StatePublished - Sep 2010
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)


  • Alcohol misuse
  • Cognitive-behavioral therapy
  • Comorbidity
  • Posttraumatic stress
  • Substance abuse


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