title: Examining the interactive effect of posttraumatic stress disorder, distress tolerance, and gender on residential substance use disorder treatment retention.
abstract: An extensive body of research has demonstrated that patients with a co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) diagnosis are at high risk for a wide range of negative clinical outcomes, including treatment noncompletion. However, no studies to date have explored the effect of a PTSD-SUD diagnosis on residential SUD treatment completion, as well as potential moderators of this effect. Consequently, the goal of this study was to examine the interactive effect of a PTSD diagnosis, distress tolerance (DT), and gender on residential SUD treatment retention. Participants were 214 substance-dependent patients consecutively admitted to a residential SUD treatment facility. Participants were administered diagnostic interviews, completed a laboratory-based measure of DT, and were followed throughout the course of treatment. Although no significant main effects were found, results did reveal a significant PTSD × gender × DT interaction. Post hoc analyses indicated that, among men, those with a current diagnosis of PTSD and low DT completed a significantly lower proportion of residential SUD treatment compared to all other groups. The implications of the study's findings for identifying ways to improve residential SUD treatment retention among patients with a PTSD-SUD diagnosis are discussed.
authors.affiliation: Department of Psychiatry and Human Behavior, University of Mississippi Medical Center.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Tull
authors.forename: Kim L
authors.initials: KL
authors.lastname: Gratz
authors.forename: Scott F
authors.initials: SF
authors.lastname: Coffey
authors.forename: Nicole H
authors.initials: NH
authors.lastname: Weiss
authors.forename: Michael J
authors.initials: MJ
authors.lastname: McDermott
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D012114:Residential Treatment; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*; D019966:Substance-Related Disorders / Q000523:psychology*; D055815:Young Adult