Lagged effects of substance use on PTSD severity in a randomized controlled trial with modified prolonged exposure and relapse prevention.
Lagged effects of substance use on PTSD severity in a randomized controlled trial with modified prolonged exposure and relapse prevention.
复制标题
DOI：
10.1037/ccp0000345
复制
发表时间：
2018-10
影响因子：
5.9
通讯作者：
Papini S
中科院分区：
文献类型：
--
作者：
Hien DA;Smith KZ;Owens M;López-Castro T;Ruglass LM;Papini S
为了进一步了解创伤后应激和物质使用障碍（PTSD和SUD）共病的循证治疗的有效性，研究必须提供更细致入微的画面，了解物质使用在治疗过程中如何影响PTSD症状的变化，以及长时间暴露技术在活性物质使用期间是否有效。一个包括PTSD/阈下PTSD和SUD患者的数据集，这些患者接受了基于暴露的干预，为进行二次分析提供了机会，以测试患者的物质使用如何影响治疗过程中PTSD的变化。我们将生长模型应用于PTSD和SUD的两种认知行为治疗的随机对照试验：使用延长暴露（COPE）和复发预防治疗（RPT）同时治疗PTSD和SUD期间的每周PTSD症状和物质使用变化。交叉滞后分析用于确定前一周药物使用是否影响随后的PTSD症状严重程度。两种治疗方法均能显著降低PTSD症状的严重程度。在持续使用药物的情况下，结果表明个人仍然受益于基于暴露的治疗。结果表明，RPT和COPE都能显著降低PTSD的发病率，这进一步支持了为SUD量身定制的基于暴露的技术可以在不损害PTSD或SUD预后的情况下进行。对临床决策围绕治疗选择的影响进行了讨论。
To advance understanding the effectiveness of evidence-based treatments for comorbid posttraumatic stress and substance use disorders (PTSD and SUD), research must provide a more nuanced picture of how substance use affects change in PTSD symptoms over the course of treatments, and whether prolonged exposure techniques can be efficacious during active substance use. A dataset that included patients with PTSD/subthreshold PTSD and SUD treated with an exposure-based intervention provided an opportunity to conduct a secondary analysis to test how patients’ substance use impacted PTSD change over treatment. We applied growth models to week-to-week PTSD symptom and substance use changes during treatment and follow-up of a randomized controlled trial of two cognitive behavioral treatments for PTSD and SUD: Concurrent Treatment of PTSD and SUD Using Prolonged Exposure (COPE) and Relapse Prevention Therapy (RPT). Cross-lagged analyses were used to determine whether prior week substance use impacted subsequent PTSD symptom severity. Both treatments evidenced significant reductions in PTSD symptom severity. In the context of continued substance use, results suggest that individuals still benefit from exposure-based treatment. Results provide evidence that RPT and COPE both led to significant reductions in PTSD, providing further support that exposure-based techniques tailored for SUD can be conducted without jeopardizing PTSD or SUD outcomes. Implications for clinical decision-making around treatment selection are discussed.
登录
查看更多内容
影响因子：
4.1
作者：
Kaczkurkin, Antonia N.;Asnaani, Anu;Foa, Edna B.
通讯作者：
Foa, Edna B.
影响因子：
1.9
作者：
Grubaugh, AL;Magruder, KM;Frueh, BC
通讯作者：
Frueh, BC
影响因子：
17.7
作者：
Hien, Denise A.;Jiang, Huiping;Nunes, Edward V.
通讯作者：
Nunes, Edward V.
影响因子：
7
作者：
Biesanz, JC;Deeb-Sossa, N;Curran, PJ
通讯作者：
Curran, PJ
影响因子：
5.9
作者：
Feingold, Alan
通讯作者：
Feingold, Alan