During treatment changes in substance abuse patients with posttraumatic stress disorder. The influence of specific interventions and program environments.
Male substance abuse patients with posttraumatic stress disorder (PTSD) (SA-PTSD; N = 140) were compared to patients with only substance use disorders (SA-only; N = 1,262), and those with other Axis I diagnoses (SA-PSY; N = 228) on changes during substance abuse treatment. Diagnoses were determined by chart review, and patients completed questionnaires assessing coping, cognitions, and psychological distress. Although SA-PTSD patients improved on outcomes during treatment, they showed less benefit relative to SA-only patients. At discharge, SA-PTSD patients reported less use of effective coping styles, and endorsed more positive beliefs about substance use than SA-only patients. They had more psychological distress than SA-only and SA-PSY patients. More counseling sessions devoted to substance abuse and family problems, and increased involvement in 12-step activities partially counteracted the negative effects of having a PTSD diagnosis on several outcomes. SA-PTSD patients reported fewer psychological symptoms at discharge in programs that were high in support and order/organization.
Ouimette
P C
PC
Program Evaluation, Veterans Affairs Palo Alto Health Care System, CA, USA. Ouimette@boris.icon.palo-alto.med.va.gov
Ahrens
C
C
Moos
R H
RH
Finney
J W
JW
D000223:Adaptation, Psychological; D000328:Adult; D016009:Chi-Square Distribution; D003071:Cognition; D003376:Counseling; D006801:Humans; D008297:Male; D010358:Patient Participation; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000523:psychology / Q000628:therapy*; D019966:Substance-Related Disorders / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014728:Veterans