Response-to-Treatment for Comorbid Post-Traumatic Stress and Substance Use Disorders: the Value of Combining Person- and
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Response-to-Treatment for Comorbid Post-Traumatic Stress and Substance Use Disorders: the Value of Combining Personand Variable-Centered Approaches Nicholas P. Allan 1 & Teresa López-Castro 2 & Denise A. Hien 3 & Santiago Papini 4 & Therese K. Killeen 5 & Daniel F. Gros 5,6 & Lesia M. Ruglass 2 & Emma Barrett 5 & Sudie E. Back 5,6
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Optimizing treatment for co-occurring post-traumatic stress disorder and substance use disorder (PTSD+SUD) is critically important. Whereas treatments have been designed that target PTSD+SUD with some success, these treatments do not benefit all. Data-driven approaches that combine person- and variable-centered methods, such as parallel process latent class growth analysis (PP-LCGA) can be used to identify response-to-treatment trajectories across both PTSD symptoms and substance use. The current study employed PP-LCGA separately in two randomized clinical trials (study 1 n = 81, Mean age = 40.4 years, SD = 10.7; study 2 n = 59, Mean age = 44.7 years, SD = 9.4) to examine PTSD symptom response and percentage of days using substances across treatment trials comparing Concurrent Treatment of PTSD and SUD using Prolonged Exposure and Relapse Prevention. Results revealed four PTSD+SUD profiles for study one and three PTSD+SUD profiles for study two. For PTSD symptoms, response trajectories could be broadly classified into treatment responders and non-responders across both studies. For substance use, response trajectories could be broadly classified into declining, moderately stable, and abstaining profiles. When considering PTSD symptoms and substance use trajectories together, profiles emerged that would have been missed had these treatment outcomes been considered separately. Keywords Post-traumatic stress disorder . Substance use disorder . Intervention . Growth mixture modeling
The co-occurrence of PTSD and SUD is startlingly common. Lifetime PTSD prevalence within SUD treatment-seeking samples is nearly three times higher than the general population and has ranged between 36% and 52% (Gielen et al.
* Nicholas P. Allan [email protected] 1
Department of Psychology, Ohio University, Athens, OH, United States
2
Department of Psychology, The City College of New York, New York, NY, United States
3
Gordon F. Derner Institute of Advanced Psychological Studies, Adelphi, Garden City, NY, United States
4
Department of Psychology, University of Texas, Austin, TX, United States
5
Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
6
Mental Health Service Line, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States
2012; Kessler et al. 1995; Reynolds et al. 2005). For individuals currently diagnosed with PTSD, problems with substances have been documented between 19% to 35% of the sample (McCauley et al. 2012). Comorbidity with alcohol use disorder is more the norm than the exception in PTSD samples with studies reporting t
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