title: Changes in coping behavior in a randomized controlled trial of concurrent treatment for PTSD and alcohol dependence.
abstract: The current study examines changes in coping among 165 adults meeting DSM-IV criteria for co-morbid posttraumatic stress disorder (PTSD) and alcohol dependence (AD).
  
  
  
  Participants were randomized to receive naltrexone or placebo, with or without prolonged exposure (PE). All participants received supportive counseling focused on alcohol use (BRENDA). Assessments of coping, PTSD, and AD were conducted at pre-treatment, mid-treatment, post-treatment, 3-month follow-up, and 6-month follow-up.
  
  
  
  Participants exhibited significant decreases in both avoidant coping and adaptive coping from pre-treatment to 6-month follow-up across all groups. Participants who received PE showed faster decreases in avoidant coping during this period than participants who did not receive PE. PTSD symptom reduction was associated with changes in both avoidant and adaptive coping across groups. Improvement in PTSD symptoms was related to a faster rate of reduction in avoidant coping in the PE groups compared to those receiving BRENDA alone.
  
  
  
  The current results suggest that concurrent treatment for co-morbid PTSD-AD decreases avoidant and adaptive coping, and participants who show greater reductions in PTSD symptoms also show greater changes in coping style. Consistent with theorized mechanisms of change in PE, the addition of PE to supportive counseling for AD was associated with a greater reduction of avoidant coping than supportive counseling alone.
authors.affiliation: University of Pennsylvania, Philadelphia, PA, USA. Electronic address: yinyinz@mail.med.upenn.edu.
authors.forename: Yinyin
authors.initials: Y
authors.lastname: Zang
authors.affiliation: Rutgers, The State University of New Jersey, Piscataway, NJ, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Yu
authors.affiliation: University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Chazin
authors.affiliation: University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Anu
authors.initials: A
authors.lastname: Asnaani
authors.affiliation: University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Laurie J
authors.initials: LJ
authors.lastname: Zandberg
authors.affiliation: University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Edna B
authors.initials: EB
authors.lastname: Foa
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000437:Alcoholism / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D003131:Combined Modality Therapy; D015897:Comorbidity; D005260:Female; D006801:Humans; D007171:Implosive Therapy; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D009292:Narcotic Antagonists; D009271:Naltrexone
keywords: Alcohol dependence; Coping; Naltrexone; PTSD; Prolonged exposure; Substance use disorder