Multisite Randomized Trial of Behavioral Interventions for Women With Co-Occurring PTSD and Substance Use Disorders

被引:228
作者
Hien, Denise A. [1 ,2 ]
Wells, Elizabeth A. [3 ]
Jiang, Huiping [4 ]
Suarez-Morales, Lourdes [5 ]
Campbell, Aimee N. C. [6 ]
Cohen, Lisa R. [7 ,8 ]
Miele, Gloria M. [7 ]
Killeen, Therese [9 ]
Brigham, Gregory S. [10 ]
Zhang, Yulei
Hansen, Cheri [11 ]
Hodgkins, Candace [12 ]
Hatch-Maillette, Mary [13 ]
Brown, Chanda [14 ]
Kulaga, Agatha [15 ]
Kristman-Valente, Allison
Chu, Melissa [16 ]
Sage, Robert [16 ]
Robinson, James A. [17 ]
Liu, David [18 ]
Nunes, Edward V. [2 ,7 ]
机构
[1] CUNY, Dept Psychol, New York, NY 10021 USA
[2] Columbia Univ Coll Phys & Surg, New York, NY 10032 USA
[3] Univ Washington, Sch Social Work, Seattle, WA USA
[4] New York State Psychiat Inst & Hosp, Div Biostat, New York, NY 10032 USA
[5] Univ Miami, Miller Sch Med, Dept Epidemiol & Publ Hlth, Ctr Studies Family, Miami, FL USA
[6] Columbia Univ, Sch Social Work, Social Intervent Grp, New York, NY 10027 USA
[7] New York State Psychiat Inst & Hosp, Subst Abuse Div, New York, NY 10032 USA
[8] CUNY City Coll, Res Ctr Trauma & Addict, Dept Psychol, New York, NY USA
[9] Med Univ S Carolina, Inst Psychiat, Charleston, SC USA
[10] Maryhaven Inc, Columbus, OH USA
[11] VillageSouth Inc, Miami, FL USA
[12] Gateway Community Serv, Jacksonville, FL USA
[13] Univ Washington, Inst Alcohol & Drug Abuse, Seattle, WA USA
[14] Charleston Ctr, Charleston, SC USA
[15] NYU, Dept Psychiat, Sch Med, Brooklyn, NY USA
[16] Addict Res & Treatment Corp, Brooklyn, NY USA
[17] Nathan S Kline Inst Psychiat Res, Orangeburg, NY 10962 USA
[18] Ctr Clin Trials Network, Natl Inst Drug Abuse, Bethesda, MD USA
关键词
PTSD; substance abuse; comorbidity; cognitive-behavioral treatment; randomized control trial; POSTTRAUMATIC-STRESS-DISORDER; ABUSE TREATMENT; SEEKING-SAFETY; PSYCHIATRIC-DISORDERS; TRAUMA; CLINICIAN; OUTCOMES; THERAPY; PREVALENCE; INSTRUMENT;
D O I
10.1037/a0016227
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
The authors compared the effectiveness of the Seeking Safety group, cognitive-behavioral treatment for substance use disorder and posttraumatic stress disorder (PTSD), to an active comparison health education group (Women's Health Education [WHE]) within the National Institute on Drug Abuse's Clinical Trials Network. The authors randomized 353 women to receive 12 sessions of Seeking Safety (M = 6.2 sessions) or WHE (M = 6.0 sessions) with follow-up assessment I week and 3, 6, and 12 months posttreatment. Primary outcomes were the Clinician Administered PTSD Scale (CAPS), the PTSD Symptom Scale-Self Report (PSS-SR), and a substance use inventory (self-reported abstinence and percentage of days of use over 7 days). Intention-to-treat analysis showed large, clinically significant reductions in CAPS and PSS-SR symptoms (d = 1.94 and 1.12, respectively) but no reliable difference between conditions. Substance use outcomes were not significantly different over time between the two treatments and at follow-up showed no significant change from baseline. Study results do not favor Seeking Safety over WHE as an adjunct to substance use disorder treatment for women with PTSD and reflect considerable opportunity to improve clinical outcomes in community-based treatments for these co-occurring conditions.
引用
收藏
页码:607 / 619
页数:13
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