Toward an Improved Model of Treating Co-Occurring PTSD and Substance Use Disorders

American Journal of Psychiatry (Impact Factor: 13.56). 01/2010; 167(1):11-3. DOI: 10.1176/appi.ajp.2009.09111602
Source: PubMed
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    ABSTRACT: Students with trauma and posttraumatic stress are disproportionately at risk for heavy drinking and for alcohol-related consequences. Brief motivational interventions (BMIs) have been shown to reduce hazardous drinking in college students, and could serve as a first-line approach to reduce heavy drinking in students with trauma and posttraumatic stress (PTS). Yet the standard BMI format may not adequately address the factors that lead to hazardous drinking in these students. Here, we review the literature on PTS and hazardous drinking in college students, and highlight cognitive (self-efficacy, alcohol expectancies) and behavioral (coping strategies, emotion regulation skills, protective behaviors) factors that may link trauma and PTS to drinking risk. Incorporating these factors into standard BMIs in a collaborative way that enhances their personal relevance may enhance intervention efficacy and acceptability for these at-risk students.
    02/2015; 2(1). DOI:10.1007/s40429-015-0044-0
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    ABSTRACT: Aggressive behavior is strongly associated with both posttraumatic stress disorder (PTSD) and substance use disorders (SUD) among civilians. However, little research has examined correlates of aggression among Veterans with co-occurring PTSD and SUD. This exploratory study examined the prevalence and correlates of recent (i.e., past 30 days) and lifetime aggressive behavior among a sample of U.S. Veterans (N=97) enrolled in a study examining integrated psychosocial treatment of co-occurring PTSD/SUD. The findings revealed high rates of recent and lifetime aggressive behaviors (39.2% and 57.7%, respectively). Participants who endorsed recent aggressive behaviors were younger, had less education, more severe PTSD numbing and hyperarousal symptoms, were more likely to report recent suicidal ideation, more frequent alcohol and marijuana use, had higher rates of physical and sexual abuse, greater combat exposure, and more severe aftermath of battle experiences. Participants who endorsed lifetime aggression were younger, reported more total PTSD symptom severity, PTSD re-experiencing severity, depression severity, and fewer post-deployment stressors compared to those who did not. Logistic regression analyses indicated that education and number of drinking days were correlated with recent aggression while depression and post-deployment stressors were correlated with lifetime aggression. The findings demonstrate high rates of aggressive behaviors among Veterans with PTSD/SUD, as well as clinically relevant correlates of aggressive behaviors. Although preliminary, the findings suggest potential targets for improving assessment and treatment of Veterans with PTSD/SUD.
    Mental Health and Substance Use dual diagnosis 11/2014; 7(4):315-328. DOI:10.1080/17523281.2014.924986
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    Sucht 01/2012; 58(4):227-235. DOI:10.1024/0939-5911.a000191

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