The effect of self-compassion on integrated treatment outcomes among veterans with co-occurring AUD and PTSD.

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PROJECT SUMMARY/ABSTRACT Compared to either disorder alone, co-occurring alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) has a more complex clinical and treatment course that imposes significant health burden on veterans. Identifying novel mechanisms to improve integrated AUD/PTSD treatment outcomes is a public health priority that aligns with NIAAA’s strategic goal to advance treatment of alcohol-related conditions through the refinement of behavioral and pharmacological treatments. Self-compassion is a cognitive skill that may facilitate more effective integrated AUD/PTSD treatment. Self-compassion is proposed to function by tapping into an innate care-giving system that could interact with oxytocin’s prosocial effects such as feelings of safety and trust. The current study will leverage an ongoing NIAAA-sponsored clinical trial that is examining the efficacy of oxytocin compared to placebo to improve outcomes in an integrated behavioral treatment among veterans with AUD/PTSD. The primary goal of the proposed study is to examine the bivariate longitudinal associations between self-compassion and treatment outcomes. The secondary goal is to examine whether veterans higher in self- compassion and administered oxytocin will outperform veterans in the placebo condition. Finally, we will utilize ecological momentary assessment (EMA) to capture the associations between self-compassion, alcohol consumption and problem severity, and PTSD symptoms in a real-world context. We hypothesize that self- compassion will enable more adaptive responding to AUD and PTSD symptoms (e.g., managing craving, lapses, maladaptive thinking patterns) thereby promoting a more efficient treatment course and reducing susceptibility to risky alcohol use or relapse. This is an important and feasible project that will provide novel insights into the role of self-compassion in AUD recovery among veterans with co-occurring PTSD. This project will also provide critical training experiences necessary to facilitate the candidate’s long-term goal to be an independent alcohol researcher. Under the proposed award, the candidate will have the opportunity to 1) master the extant literature on behavioral and pharmacological interventions for AUD/PTSD; 2) acquire new skills in the design and implementation of clinical trials; 3) hone skills in naturalistic assessment methods such as EMA; 4) advance longitudinal data analytic capabilities; and 5) increase scholarly productivity through grant and manuscript development. She will accomplish these deliberately selected training goals by leading the proposed research project, engaging in a comprehensive mentorship plan with highly skilled sponsors, and participating in a carefully selected program of didactic training opportunities. The training will be carried out at the Medical University of South Carolina (MUSC) in the Addiction Sciences Division. MUSC is a renowned academic medical center known for its innovative and excellence in alcohol research. Thus, the candidate will have access to an institution and sponsors with a strong history and commitment to clinical alcohol research.