TY - JOUR
T1 - Trauma-Focused Exposure Therapy for Chronic Posttraumatic Stress Disorder in Alcohol and Drug Dependent Patients
T2 - A Randomized Controlled Trial
AU - Coffey, Scott F.
AU - Schumacher, Julie A.
AU - Nosen, Elizabeth
AU - Littlefield, Andrew K.
AU - Henslee, Amber M.
AU - Lappen, Amy
AU - Stasiewicz, Paul R.
N1 - Funding Information:
This research was supported, in part, by National Institute on Alcohol Abuse and Alcoholism Grant R01AA016816 (Principal Investigator: Scott F. Coffey). We thank M. Trost Friedler, Jackie Lampley, and the staff and patients of Harbor House Recovery Center for their cooperation on this study.
Publisher Copyright:
© 2016 American Psychological Association.
PY - 2016/11/1
Y1 - 2016/11/1
N2 - To test whether a modified version of prolonged exposure (mPE) can effectively treat posttraumatic stress disorder (PTSD) in individuals with co-occurring PTSD and substance dependence, an efficacy trial was conducted in which substance dependent treatment-seekers with PTSD (N = 126, male = 54.0%, White = 79.4%) were randomly assigned to mPE, mPE + trauma-focused motivational enhancement session (mPE + MET-PTSD), or a health information-based control condition (HLS). All participants were multiply traumatized; the median number of reported traumas that satisfied DSM-IV Criterion A for PTSD was 8. Treatment consisted of 9-12 60-min individual therapy sessions plus substance abuse treatment-as-usual. Participants were assessed at baseline, end-of-treatment, and at 3- and 6-months posttreatment. Both the mPE and mPE + MET-PTSD conditions achieved significantly better PTSD outcome than the control condition. The mPE + MET-PTSD and mPE conditions did not differ from one another on PTSD symptoms at end of treatment, 3-, or 6-month follow-up. Substance use outcomes did not differ between groups with all groups achieving 85.7%-97.9% days abstinent at follow-up. In regard to clinically significant improvement in trauma symptoms, 75.8% of the mPE participants, 60.0% of the mPE + MET-PTSD participants, and 44.4% of the HLS participants experienced clinically significant improvement at the end-of-treatment. Results indicate mPE, with or without an MET-PTSD session, can effectively treat PTSD in patients with co-occurring PTSD and substance dependence. In addition, mPE session lengths may better suit standard clinical practice and are associated with medium effect sizes.
AB - To test whether a modified version of prolonged exposure (mPE) can effectively treat posttraumatic stress disorder (PTSD) in individuals with co-occurring PTSD and substance dependence, an efficacy trial was conducted in which substance dependent treatment-seekers with PTSD (N = 126, male = 54.0%, White = 79.4%) were randomly assigned to mPE, mPE + trauma-focused motivational enhancement session (mPE + MET-PTSD), or a health information-based control condition (HLS). All participants were multiply traumatized; the median number of reported traumas that satisfied DSM-IV Criterion A for PTSD was 8. Treatment consisted of 9-12 60-min individual therapy sessions plus substance abuse treatment-as-usual. Participants were assessed at baseline, end-of-treatment, and at 3- and 6-months posttreatment. Both the mPE and mPE + MET-PTSD conditions achieved significantly better PTSD outcome than the control condition. The mPE + MET-PTSD and mPE conditions did not differ from one another on PTSD symptoms at end of treatment, 3-, or 6-month follow-up. Substance use outcomes did not differ between groups with all groups achieving 85.7%-97.9% days abstinent at follow-up. In regard to clinically significant improvement in trauma symptoms, 75.8% of the mPE participants, 60.0% of the mPE + MET-PTSD participants, and 44.4% of the HLS participants experienced clinically significant improvement at the end-of-treatment. Results indicate mPE, with or without an MET-PTSD session, can effectively treat PTSD in patients with co-occurring PTSD and substance dependence. In addition, mPE session lengths may better suit standard clinical practice and are associated with medium effect sizes.
KW - alcoholism
KW - comorbidity
KW - drug abuse
KW - exposure therapy
KW - posttraumatic stress disorder
UR - http://www.scopus.com/inward/record.url?scp=84994378203&partnerID=8YFLogxK
U2 - 10.1037/adb0000201
DO - 10.1037/adb0000201
M3 - Article
C2 - 27786516
AN - SCOPUS:84994378203
VL - 30
SP - 778
EP - 790
JO - Psychology of Addictive Behaviors
JF - Psychology of Addictive Behaviors
SN - 0893-164X
IS - 7
ER -