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


METHODS
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 (chi(2)(1)=4.00, p<.05) and follow-up (chi(2)(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 (chi(2)(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.
Department of Psychology, City University of New York, NY, USA. dah26@columbia.edu
Denise A
DA
Hien
Aimee N C
AN
Campbell
Lesia M
LM
Ruglass
Mei-Chen
MC
Hu
Therese
T
Killeen
D000437:Alcoholism / Q000150:complications* / Q000523:psychology; D016009:Chi-Square Distribution; D015928:Cognitive Behavioral Therapy; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D054577:National Institute on Drug Abuse (U.S.); D010353:Patient Education as Topic; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D014481:United States