Coping among military veterans with PTSD in substance use disorder treatment.
We longitudinally investigated coping among male military veterans (n = 98) with posttraumatic stress disorder (PTSD) symptomatology and a co-occurring substance use disorder (SUD) who participated in a randomized controlled trial of seeking safety (SS). Participants were randomized to SS or intensive treatment-as-usual (TAU) for SUD. Coping (active, avoidant, emotional discharge), and PTSD and SUD symptomatology were measured prior to and at the end of treatment, and at 6- and 12-month follow-ups. Among the total sample, we found that: (a) avoidant and emotional discharge, but not active, coping tended to be positively associated with PTSD and SUD symptomatology at baseline; (b) active coping increased and avoidant and emotional discharge coping decreased during the 12-month time-period; and (c) avoidant and emotional discharge, but not active, coping longitudinally covaried with PTSD and SUD symptomatology. Results suggest the utility of targeting maladaptive coping in treatments for individuals with co-occurring PTSD and SUD.
Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, 94025, USA. Electronic address: Matthew.Boden@va.gov.
Matthew
M
Tyler Boden
Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, 94025, USA; National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA, 94025, USA.
Rachel
R
Kimerling
VA Palo Alto Health Care System, Menlo Park, CA, 94025, USA.
Madhur
M
Kulkarni
Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, 94025, USA; National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA, 94025, USA; Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA; Center of Excellence in Substance Abuse Treatment and Education, Philadelphia VAMC, Philadelphia, PA, 19104, USA.
Marcel O
MO
Bonn-Miller
VA Palo Alto Health Care System, Menlo Park, CA, 94025, USA; Palo Alto University, Palo Alto, CA, 94304, USA.
Christopher
C
Weaver
Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, 94025, USA.
Jodie
J
Trafton
D000223:Adaptation, Psychological; D000328:Adult; D017831:Diagnosis, Dual (Psychiatry); D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology* / Q000534:rehabilitation; D019966:Substance-Related Disorders / Q000523:psychology* / Q000534:rehabilitation; D013997:Time Factors; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology*
Coping; Dual diagnosis; Posttraumatic stress disorder; Seeking safety; Substance abuse; Substance use disorder