Pre-treatment predictors of dropout from prolonged exposure therapy in patients with chronic posttraumatic stress disorder and comorbid substance use disorders.
Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) are commonly co-occurring disorders associated with more adverse consequences than PTSD alone. Prolonged exposure therapy (PE) is one of the most efficacious treatments for PTSD. However, among individuals with PTSD-SUD, 35-62% of individuals drop out of trauma-focused exposure treatments. Thus, it is important to identify predictors of PTSD treatment dropout among substance abusers with PTSD in order to gain information about adapting treatment strategies to enhance retention and outcomes. The current study explored pre-treatment predictors of early termination from PE treatment in a sample of 85 individuals receiving concurrent treatment for PTSD and a SUD in a residential treatment facility as part of a randomized controlled trial. The results indicated that less education and more anxiety sensitivity uniquely predicted PE treatment dropout. Demographic variables, PTSD severity, SUD severity, mental health comorbidities, and emotion regulation difficulties did not predict treatment dropout. These results suggest that adding pre-treatment interventions that address anxiety sensitivity, and promote social adjustment and cognitive flexibility, could possibly improve PE retention rates in clients with high anxiety or low education.
Department of Psychiatry and Human Behavior, The University of Mississippi Medical Center, United States.
Emily L
EL
Belleau
Department of Psychiatry and Human Behavior, The University of Mississippi Medical Center, United States.
Eu Gene
EG
Chin
Department of Psychiatry and Human Behavior, The University of Mississippi Medical Center, United States.
Sonya G
SG
Wanklyn
Department of Psychiatry and Human Behavior, The University of Mississippi Medical Center, United States.
Laura
L
Zambrano-Vazquez
Department of Psychiatry and Human Behavior, The University of Mississippi Medical Center, United States.
Julie A
JA
Schumacher
Department of Psychiatry and Human Behavior, The University of Mississippi Medical Center, United States. Electronic address: scoffey@umc.edu.
Scott F
SF
Coffey
D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000706:statistics & numerical data*; D008297:Male; D010352:Patient Dropouts / Q000523:psychology*; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult
Dropout; Posttraumatic stress; Prolonged exposure; Substance use; Treatment termination