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首页> 外文期刊>Journal of substance abuse treatment >Substance use predictors of attendance among veterans in integrated PTSD and alcohol use disorder treatment*
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Substance use predictors of attendance among veterans in integrated PTSD and alcohol use disorder treatment*

机译：物质使用在综合的PTSD和酒精使用障碍治疗中的退伍军人出席的预测因子*

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Comorbid post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) is common, defined by greater severity and impairment than either disorder alone, and associated with poor treatment attendance. Exposure therapies are effective in treating PTSD+AUD, yet substance use is still cited as a potential contraindication for exposure. This study examined substance use?related predictors of session attendance among veterans (N = 119) randomized to receive integrated exposure therapy (Concurrent Treatment of PTSD and Substance Use Disorders using Prolonged Exposure [COPE]; Back et al., 2015) or integrated coping skills therapy (Seeking Safety [SS]; Najavits, 2002) in a clinical trial for comorbid PTSD+AUD (Norman et al., 2019). At baseline, greater percentage of heavy drinking days (13 = - 0.23, p = .011) and greater AUD severity per structured clinical interview for DSMIV-TR (13 = -0.21, p = .019) predicted fewer sessions across both treatments. Treatment type did not moderate the relationship between predictors and attendance, except for a trend for craving (p = .057), where greater craving predicted fewer sessions in SS (13 = -0.31, p = .02) but not COPE (13 = 0.14, p = .28). Percentage of abstinence days, AUD duration, and living in a controlled environment (e.g., recovery home) at the start of therapy were not associated with attendance in either treatment condition. Only a subset of substance use characteristics predicted attendance. Findings did not support the notion that alcohol use leads to lower attendance in exposure therapy compared to nonexposure therapy.
机译：创伤后应激障碍（PTSD）和酒精使用障碍（AUD）共病很常见，其严重程度和损害程度比单独的两种障碍都要大，且与不良治疗相关。暴露疗法在治疗PTSD+AUD方面是有效的，但药物使用仍然被认为是暴露的潜在禁忌症。这项研究考察了物质使用？在一项共病PTSD+AUD临床试验（Norman等人，2019年）中，退伍军人（N=119）随机接受综合暴露疗法（同时使用长期暴露[COPE]；Back等人，2015年）或综合应对技能疗法（寻求安全[SS]；Najavits，2002年）的相关治疗出席预测因素。在基线检查时，DSMIV-TR的重度饮酒日百分比（13=-0.23，p=.011）和每次结构化临床访谈的AUD严重程度（13=-0.21，p=.019）越高，预测两种治疗的疗程越少。治疗类型并没有缓和预测因子和出勤率之间的关系，除了渴求的趋势（p=0.057），更大的渴求预测SS的疗程更少（13=-0.31，p=0.02），但没有预测COPE（13=0.14，p=0.28）。在治疗开始时，禁欲天数的百分比、AUD持续时间和生活在受控环境（如康复之家）与两种治疗条件下的出勤率无关。只有一部分物质使用特征可以预测出勤率。研究结果并不支持饮酒导致暴露疗法的参与率低于非暴露疗法的观点。

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