Temporal dynamics of symptom change among veterans receiving an integrated treatment for posttraumatic stress disorder and substance use disorders.
Temporal dynamics of symptom change among veterans receiving an integrated treatment for posttraumatic stress disorder and substance use disorders.
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DOI：
10.1002/jts.22769
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发表时间：
2022-04
影响因子：
3.3
通讯作者：
Back, Sudie E.
中科院分区：
文献类型：
--
作者：
Badour, Christal L.;Flanagan, Julianne C.;Allan, Nicholas P.;Gilmore, Amanda K.;Gros, Daniel F.;Killeen, Therese;Korte, Kristina J.;Brown, Delisa G.;Kolnogorova, Kateryna;Back, Sudie E.
本研究考察了共病创伤后应激障碍（PTSD）和物质使用障碍（sud）治疗期间症状变化的时间模式。我们假设创伤后应激障碍症状的严重程度可以预测随后的药物使用，并且这种关联在接受综合治疗的患者中与仅接受sud治疗的患者中尤为强烈。参与者是81名患有PTSD和SUD的美国退伍军人，他们参加了一项为期12周的随机对照试验，研究了使用长时间暴露同时治疗PTSD和物质使用障碍（COPE）与认知行为复发预防疗法（RP）的疗效。滞后的多水平模型显示，PTSD症状改善不能显著预测下一次药物使用的可能性（使用可能性：B = 0.03, SE = 0.02, p = 0.141；使用B的天数百分比= - 0.02,SE = 0.01, p = 0.172）。物质使用（B = 1.53, SE = 1.79, p = 0.391）和使用频率（B = 0.26, SE = 0.50, p = 0.612）均不能预测两种治疗条件下下一次PTSD症状的严重程度。根据自我药物治疗假说，PTSD症状与下一阶段药物使用之间存在更强的关联。需要进一步的研究来更好地了解症状变化的时间动态以及症状变化的具体介质和机制。
The present study examined temporal patterns of symptom change during treatment for comorbid posttraumatic stress disorders (PTSD) and substance use disorders (SUDs). We hypothesized that PTSD symptom severity would predict subsequent-session substance use and that this association would be particularly strong among patients who received an integrated treatment versus SUD-only treatment. Participants were 81 United States military veterans with current PTSD and an SUD who were enrolled in a 12-week, randomized controlled trial examining the efficacy of an integrated treatment called Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE) compared with cognitive behavioral relapse prevention therapy (RP). Lagged multilevel models indicated that PTSD symptom improvement did not significantly predict the likelihood of next-session substance use (likelihood of use: B = 0.03, SE = 0.02, p = .141; percentage of days using B = −0.02, SE = 0.01, p = .172. Neither substance use, B = 1.53, SE = 1.79, p = .391, nor frequency of use, B = 0.26, SE = 0.50, p = .612, predicted next-session PTSD symptom severity in either treatment condition. Stronger associations between PTSD symptoms and next-session substance use were expected given the self-medication hypothesis. Additional research is needed to better understand the temporal dynamics of symptom change as well as the specific mediators and mechanisms underlying symptom change.
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