Do PTSD symptoms and course predict continued substance use for homeless individuals in contingency management for cocaine dependence?
Do PTSD symptoms and course predict continued substance use for homeless individuals in contingency management for cocaine dependence?
复制标题
DOI：
10.1016/j.brat.2010.03.010
复制
发表时间：
2010-07
影响因子：
4.1
通讯作者：
Schumacher JE
中科院分区：
文献类型：
--
作者：
Burns MN;Lehman KA;Milby JB;Wallace D;Schumacher JE
无家可归的个人（n = 187）进入应急管理（CM）可卡因依赖的PTSD诊断进行了评估，和一个子集的102名参与者报告创伤暴露也定期完成了自我报告的PTSD症状的措施。在6个月（积极治疗结束）和12个月（善后护理结束）完全缓解的PTSD患者在善后护理期间使用物质的频率比没有PTSD诊断的患者低得多。那些在积极治疗期间PTSD诊断改善到完全缓解状态，并在12个月时保持完全缓解的患者，也有上级物质使用结果。在6个月时，PTSD症状的严重程度，而不是基线或2个月，与治疗阶段的物质使用相关。然而，通过PTSD症状严重程度的变化可以更好地预测善后护理期间的物质使用。在积极治疗过程中PTSD症状改善较多的患者在善后护理过程中的表现优于改善较少的患者。研究结果表明，与那些没有合并症的人相比，患有PTSD的无家可归者因可卡因依赖而进入CM并不一定会增加物质使用的风险。然而，PTSD的病程确实可以预测物质的使用，对于那些对PTSD有实质性、持久性改善的人来说，CM可能是非常有效的。
Homeless individuals (n = 187) entering contingency management (CM) for cocaine dependence were assessed for PTSD diagnosis, and a subset of 102 participants reporting traumatic exposure also periodically completed a self-report measure of PTSD symptoms. Patients with PTSD in full remission at 6 months (end of active treatment) and 12 months (end of aftercare) used substances much less frequently during aftercare than those with no PTSD diagnosis. Those whose PTSD diagnosis improved to full remission status during active treatment, and remained in full remission at 12 months, also had superior substance use outcomes. Severity of PTSD symptoms at 6 months, but not baseline or 2 months, was associated with substance use across treatment phases. Substance use during aftercare, however, was better predicted by changes in PTSD symptom severity. Patients whose PTSD symptoms improved more during active treatment fared better during aftercare than those with less improvement. Findings suggest homeless individuals with comorbid PTSD entering CM for cocaine dependence are not necessarily at increased risk for substance use compared to those without the comorbidity. However, course of PTSD does predict substance use, with the potential for CM to be unusually effective for those who respond with substantial, lasting improvements in PTSD.
登录
查看更多内容
影响因子：
3.9
作者：
Hien, DA;Nunes, E;Fraser, D
通讯作者：
Fraser, D
影响因子：
6
作者：
Higgins, Stephen T.;Heil, Sarah H.;Badger, Gary J.
通讯作者：
Badger, Gary J.
影响因子：
2.7
作者：
Avants, SK;Warburton, LA;Margolin, A
通讯作者：
Margolin, A
影响因子：
3.8
作者：
Ilgen, Mark A.;Moos, Rudolf H.
通讯作者：
Moos, Rudolf H.
影响因子：
6
作者：
DeFulio, Anthony;Donlin, Wendy D.;Silverman, Kenneth
通讯作者：
Silverman, Kenneth