Examining Pretreatment Differences Between Veterans in Residential Versus Outpatient Treatment for Alcohol Use Disorder and Comorbid Combat-Related PTSD.
Veterans with alcohol use disorder (AUD) and co-occurring posttraumatic stress disorder (PTSD) have access to various residential and outpatient treatment programs through the VA Healthcare System. There is a need to better understand the characteristics and needs of veterans who engage in residential versus outpatient treatment in order to help inform veteran care and decisions about treatment services.



The present study examined whether veterans with both AUD and combat-related PTSD who were enrolled in residential (n = 103) or outpatient treatment programs (n = 76) differed on pretreatment psychiatric symptoms, substance use and associated problems/behaviors, or demographics. Veterans completed self-report measures (which referenced symptoms in the past 30 days or 2 weeks) within the first week of PTSD/AUD treatment.



Veterans in residential treatment had slightly worse PTSD symptoms compared to outpatient veterans; the groups reported similar levels of depression symptoms. Residential veterans had higher frequency of drug use, were more confident in their ability to be abstinent, attended more self-help meetings, spent more time around risky people or places, were more satisfied with their progress toward recovery goals, were more bothered by arguments with family/friends, and spent fewer days at work or school compared to outpatient veterans; the groups did not differ on drinking (frequency of use, binge drinking) or cravings. With respect to demographics, residential veterans were more likely to be married and non-Hispanic Caucasian (rather than minority races/ethnicities) compared to outpatient veterans.



The finding that PTSD symptoms were more severe among veterans in residential substance use treatment highlights the importance of taking advantage of this crucial opportunity to engage veterans in evidence-based PTSD treatment. Consistent with other research, findings also indicated that individuals entering residential care have a higher level of impairment than those beginning outpatient care.
a VA San Diego Healthcare System , San Diego , California , USA.|b University of California , San Diego, San Diego , California , USA.
Moira
M
Haller
a VA San Diego Healthcare System , San Diego , California , USA.|c VA Center of Excellence for Stress and Mental Health , San Diego , California , USA.
Peter J
PJ
Colvonen
a VA San Diego Healthcare System , San Diego , California , USA.|b University of California , San Diego, San Diego , California , USA.
Brittany C
BC
Davis
a VA San Diego Healthcare System , San Diego , California , USA.|b University of California , San Diego, San Diego , California , USA.
Ryan S
RS
Trim
a VA San Diego Healthcare System , San Diego , California , USA.
Rebecca
R
Bogner
a VA San Diego Healthcare System , San Diego , California , USA.
John
J
Sevcik
a VA San Diego Healthcare System , San Diego , California , USA.|b University of California , San Diego, San Diego , California , USA.|c VA Center of Excellence for Stress and Mental Health , San Diego , California , USA.|d National Center for PTSD, White River Junction , Vermont , USA.
Sonya B
SB
Norman
D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D000553:Ambulatory Care; D003130:Combat Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services; D020380:Needs Assessment; D012114:Residential Treatment; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D014728:Veterans / Q000523:psychology*
Residential; alcohol use disorder; outpatient; posttraumatic stress disorder; treatment