title: To reduce or abstain? Substance use goals in the treatment of veterans with substance use disorders and comorbid PTSD.
abstract: BACKGROUND
  Posttraumatic stress disorder (PTSD) and substance use disorders (SUD) frequently co-occur. Previous research demonstrates the utility of goals in attaining improved SUD outcomes, however, no previous studies have examined goal choices in the context of integrated treatment for comorbid PTSD and SUD.
  
  
  OBJECTIVE
  The present study investigated correlates of treatment entry goals to either reduce or abstain from substance use.
  
  
  METHODS
  Participants (N = 60) were treatment-seeking veterans with current PTSD and SUD. Participants completed self-report and clinician-rated measures of substance use, PTSD, and affective symptoms as part of a larger randomized controlled trial.
  
  
  RESULTS
  Half (30/60) of participants endorsed a treatment entry goal to reduce substance use (reducers). Compared to participants who endorsed a treatment entry goal of abstinence (abstainers), reducers were significantly younger, more likely to be employed, more likely to have served in recent military conflicts (Operations Enduring/Iraqi Freedom), and endorsed significantly fewer symptoms of alcohol dependence.
  
  
  CONCLUSIONS
  The findings demonstrate clinically relevant differences based on treatment entry goals, suggesting that individuals are often able to choose conceivably appropriate treatment goals based, most notably, on the severity of their SUD. Collaboratively engaging patients in establishing treatment goals that are consistent with their beliefs and desires in conjunction with empirical findings is particularly relevant in the context of treatment for SUD and PTSD where many patients are ambivalent about treatment and attrition is common.
authors: Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina.|Medical University of South Carolina, Charleston, South Carolina.
authors: Brian E
authors: BE
authors: Lozano
authors: Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina.|Medical University of South Carolina, Charleston, South Carolina.
authors: Daniel F
authors: DF
authors: Gros
authors: Medical University of South Carolina, Charleston, South Carolina.
authors: Therese
authors: T
authors: Killeen
authors: Medical University of South Carolina, Charleston, South Carolina.
authors: Maryanne
authors: M
authors: Jaconis
authors: Medical University of South Carolina, Charleston, South Carolina.
authors: Francis M
authors: FM
authors: Beylotte
authors: Medical University of South Carolina, Charleston, South Carolina.
authors: Stephen
authors: S
authors: Boyd
authors: Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina.|Medical University of South Carolina, Charleston, South Carolina.
authors: Sudie E
authors: SE
authors: Back
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D005260:Female; D006040:Goals; D006801:Humans; D008297:Male; D008875:Middle Aged; D013022:South Carolina / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology*; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology*; D014728:Veterans / Q000523:psychology*; D055815:Young Adult