Using the research domain criteria framework to track domains of change in comorbid PTSD and SUD.
OBJECTIVE
Comorbidity in diagnosis raises critical challenges for psychological assessment and treatment. The Research Domain Criteria (RDoC) Project, launched by the National Institutes of Mental Health, proposes domains of functioning as a way to conceptualize the overlap between comorbid conditions and inform treatment selection. However, further research is needed to understand common comorbidities (e.g., posttraumatic stress disorder [PTSD] and substance use disorder [SUD]) from an RDoC framework and how existing evidence-based treatments would be expected to promote change in the RDoC domains of functioning. To address these gaps, the current study examined change in 3 RDoC domains (Negative Valence Systems, Arousal/Regulatory Systems, and Cognitive Systems) during concurrent prolonged exposure (PE) and substance use treatment.


METHODS
Participants were 85 individuals with co-occurring PTSD and SUD who received PE in a residential substance use treatment facility. They completed an experimental task to assess physiological reactivity to trauma and alcohol cues at pre- and posttreatment.


RESULTS
Results showed decreased severity in all 3 RDoC domains of interest across the study period. Pairwise comparisons between domains revealed that Arousal/Regulatory Systems had the lowest severity at posttreatment. Subsequent hierarchical linear regression analyses showed that posttreatment domain scores were associated with posttreatment cue reactivity for trauma and alcohol cues.


CONCLUSIONS
The findings provide preliminary evidence of how the RDoC domains of functioning may change with evidence-based treatments and are discussed in terms of the assessment and treatment of mental health problems using the RDoC framework. (PsycINFO Database Record
University of Mississippi Medical Center.
Laura
L
Zambrano-Vazquez
Department of Psychiatry and Human Behavior, University of Mississippi Medical Center.
Hannah C
HC
Levy
Department of Psychiatry and Human Behavior, University of Mississippi Medical Center.
Emily L
EL
Belleau
Department of Psychiatry and Human Behavior, University of Mississippi Medical Center.
Emily R
ER
Dworkin
Department of Psychiatry and Human Behavior, University of Mississippi Medical Center.
Katianne M
KM
Howard Sharp
Department of Psychiatry and Human Behavior, University of Mississippi Medical Center.
Samantha L
SL
Pittenger
Department of Psychiatry and Human Behavior, University of Mississippi Medical Center.
Julie A
JA
Schumacher
Department of Psychiatry and Human Behavior, University of Mississippi Medical Center.
Scott F
SF
Coffey
D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D005260:Female; D000070497:Healthy Lifestyle; D006801:Humans; D007171:Implosive Therapy; D007406:Interview, Psychological; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012114:Residential Treatment; D057566:Self Report; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D019966:Substance-Related Disorders / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult