Multisite randomized trial of behavioral interventions for women with co-occurring PTSD and substance use disorders.
The authors compared the effectiveness of the Seeking Safety group, cognitive-behavioral treatment for substance use disorder and posttraumatic stress disorder (PTSD), to an active comparison health education group (Women's Health Education [WHE]) within the National Institute on Drug Abuse's Clinical Trials Network. The authors randomized 353 women to receive 12 sessions of Seeking Safety (M = 6.2 sessions) or WHE (M = 6.0 sessions) with follow-up assessment 1 week and 3, 6, and 12 months posttreatment. Primary outcomes were the Clinician Administered PTSD Scale (CAPS), the PTSD Symptom Scale-Self Report (PSS-SR), and a substance use inventory (self-reported abstinence and percentage of days of use over 7 days). Intention-to-treat analysis showed large, clinically significant reductions in CAPS and PSS-SR symptoms (d = 1.94 and 1.12, respectively) but no reliable difference between conditions. Substance use outcomes were not significantly different over time between the two treatments and at follow-up showed no significant change from baseline. Study results do not favor Seeking Safety over WHE as an adjunct to substance use disorder treatment for women with PTSD and reflect considerable opportunity to improve clinical outcomes in community-based treatments for these co-occurring conditions.
Hien
Denise A
DA
Department of Psychology, City University of New York, City College of New York, New York, NY 10030, USA. dah26@columbia.edu
Wells
Elizabeth A
EA
Jiang
Huiping
H
Suarez-Morales
Lourdes
L
Campbell
Aimee N C
AN
Cohen
Lisa R
LR
Miele
Gloria M
GM
Killeen
Therese
T
Brigham
Gregory S
GS
Zhang
Yulei
Y
Hansen
Cheri
C
Hodgkins
Candace
C
Hatch-Maillette
Mary
M
Brown
Chanda
C
Kulaga
Agatha
A
Kristman-Valente
Allison
A
Chu
Melissa
M
Sage
Robert
R
Robinson
James A
JA
Liu
David
D
Nunes
Edward V
EV
D000293:Adolescent; D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education; D006801:Humans; D008875:Middle Aged; D010555:Personality Inventory; D011615:Psychotherapy, Group / Q000379:methods*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult