Sequence of Symptom Change During AUD or PTSD Treatment for Comorbid PTSD/AUD
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 7/20/2018 |
| Start Date: | March 2013 |
| End Date: | January 2019 |
Sequence of Symptom Change During AUD (Alcohol Use or Dependence) or PTSD (Posttraumatic Stress Disorder) Treatment for Comorbid PTSD/AUD
The broad, long-term objective of the current research is to improve treatment outcomes for
individuals with comorbid posttraumatic stress disorder (PTSD) and alcohol abuse and
dependence (AUD).
The purpose of which is to evaluate changes in both PTSD symptoms and alcohol use and
cravings associated with Cognitive Processing Therapy (CPT) or Relapse Prevention (RP)
treatment in individuals with PTSD/AUD, along with mediators and moderators of outcomes.
The study will randomize 235 PTSD/AUD participants recruited from the VA and from the
community to CPT, RP, or Interactive Voice Response (IVR) assessment only (AO). Those in the
AO condition will be re-randomized after the treatment phase to either RP or CPT. Individuals
will be assessed pretreatment, immediately post-treatment, 3-, 6-, 9-, and 12-months
post-treatment and will monitor symptoms daily throughout treatment.
individuals with comorbid posttraumatic stress disorder (PTSD) and alcohol abuse and
dependence (AUD).
The purpose of which is to evaluate changes in both PTSD symptoms and alcohol use and
cravings associated with Cognitive Processing Therapy (CPT) or Relapse Prevention (RP)
treatment in individuals with PTSD/AUD, along with mediators and moderators of outcomes.
The study will randomize 235 PTSD/AUD participants recruited from the VA and from the
community to CPT, RP, or Interactive Voice Response (IVR) assessment only (AO). Those in the
AO condition will be re-randomized after the treatment phase to either RP or CPT. Individuals
will be assessed pretreatment, immediately post-treatment, 3-, 6-, 9-, and 12-months
post-treatment and will monitor symptoms daily throughout treatment.
Prior research has established that PTSD and AUD are frequently comorbid.
Although combined treatments have been developed, they are complex and lengthy with mixed
results as to their efficacy. Excellent treatments exist for PTSD or AUD alone, however, it
has not been adequately addressed to what extent these treatments are effective in treating
comorbid symptom presentations. To address this research gap, the investigators will evaluate
two widely accepted treatments for each respective disorder; Cognitive Processing Therapy
(CPT) an effective PTSD treatment and Relapse Prevention (RP), a widely used effective AUD
treatment.
The investigators will build on our prior work using a daily telephone Interactive Voice
Response (IVR) system to test models of self-medication and the sequence of symptom change
for both primary and secondary symptom targets associated with each therapy.
Creating a more comprehensive model of symptom change in PTSD and alcohol use with widely
used selective treatments is critical in testing theories of PTSD/AUD, evaluating these
treatments for use with PTSD/AUD, and implementing these therapies with PTSD/AUD patients in
standard clinical practice
Although combined treatments have been developed, they are complex and lengthy with mixed
results as to their efficacy. Excellent treatments exist for PTSD or AUD alone, however, it
has not been adequately addressed to what extent these treatments are effective in treating
comorbid symptom presentations. To address this research gap, the investigators will evaluate
two widely accepted treatments for each respective disorder; Cognitive Processing Therapy
(CPT) an effective PTSD treatment and Relapse Prevention (RP), a widely used effective AUD
treatment.
The investigators will build on our prior work using a daily telephone Interactive Voice
Response (IVR) system to test models of self-medication and the sequence of symptom change
for both primary and secondary symptom targets associated with each therapy.
Creating a more comprehensive model of symptom change in PTSD and alcohol use with widely
used selective treatments is critical in testing theories of PTSD/AUD, evaluating these
treatments for use with PTSD/AUD, and implementing these therapies with PTSD/AUD patients in
standard clinical practice
Inclusion Criteria:
- Men and women age ≥ 18 years with a current DSM-V diagnosis of alcohol
abuse/dependence
- Recent alcohol consumption for at least 2 weeks in the past 30 day period OR at least
2 days of heavy drinking in the past 30 day period
- Desire to abstain from alcohol
- Current DSM-V (Diagnostic and Statistical Manual of Mental Disorders) diagnosis of
PTSD
- Capacity to provide informed consent
- English fluency
Exclusion Criteria:
- Men and women with an unstable psychiatric medication regimen
- Current trauma-focused mental health treatment (MH) or behaviorally focused alcohol
dependence (AD) AD/MH treatment in the past 30 days
- Suicide attempt or suicidal ideation with intent or plan, or self-harm in the past
month
- Presence of a psychotic disorder or uncontrolled Bipolar Disorder
- Signs or symptoms of alcohol withdrawal at the time of initial consent
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