Cognitive Processing Therapy or Relapse Prevention for comorbid Posttraumatic Stress Disorder and Alcohol Use Disorder: A randomized clinical trial

Simpson, Tracy L.; Kaysen, Debra; Fleming, Charles B.; Rhew, Isaac C.; Jaffe, Anna E.; Desai, Sruti; Hien, Denise A.; Berliner, Lucy; Donovan, Dennis M.; Resick, Patricia A.

doi:10.1371/journal.pone.0276111

Cited by 11 publications

(5 citation statements)

References 67 publications

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“…Indeed, previous research has shown that emotion regulation change coincides with a treatment-related change in PTSD (Jerud et al, 2016), likely due to the fact that the use of maladaptive emotion regulation strategies is associated with PTSD symptom severity (Boden et al, 2013; Ehring & Quack, 2010; Tull et al, 2007). Additionally, treatments targeting alcohol use can lead to reductions in co-occurring PTSD (Simpson et al, 2020). More research is needed to understand the sequence of symptom change and whether there are advantages to targeting emotion regulation and drinking for downstream improvements in other symptoms.…”

Section: Discussionmentioning

confidence: 99%

Initial efficacy of a web-based alcohol and emotion regulation intervention for college women with sexual assault histories.

Stappenbeck¹,

Gulati²,

Jaffe³

et al. 2021

Psychology of Addictive Behaviors

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Objective: College women with sexual assault histories report greater heavy drinking relative to those without histories of assault. Moreover, individuals with sexual assault histories often have difficulty regulating emotions and tolerating distress, which can lead to a problematic pattern of drinking to cope. Thus, we evaluated the initial efficacy of a web-based alcohol intervention that included strategies to reduce drinking and improve regulatory skills for heavy drinking college women with sexual assault histories. Method: The sample comprised college women (N = 200) who were 20.9 (SD = 2.8) years old and primarily White (69%). They were randomized to an assessment-only control or intervention and completed 14 daily diary assessments, pre-and posttreatment surveys, and 1-and 6-month follow-up surveys. During daily diary, the intervention group received a brief (5-10 min) alcohol reduction or regulatory skill module each day. Results: Reductions in drinking quantity and heavy episodic drinking were found for the intervention group at posttreatment and 1-month follow-up relative to controls. Improved regulatory skills and reduced posttraumatic stress disorder (PTSD) symptoms were reported at posttreatment for women who received the intervention compared to controls. Although gains were maintained, the intervention group no longer differed from controls by 6-month follow-up. Conclusions: Results suggest this web-based intervention may result in short-term reductions in drinking and PTSD symptoms as well as improvements in regulatory abilities for college women with sexual assault histories. Public Health Significance StatementThis brief web-based intervention was designed to address the unique needs of heavy drinking college women with sexual assault histories in a way that minimized barriers to care and met the women where they are, with potential to have a broad positive impact on postassault functioning given the relative ease of dissemination and implementation. Results highlight the utility of integrating regulatory skills alongside alcohol reduction strategies to reduce alcohol use and improve other indicators of functioning among college women with sexual assault histories.

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Section: Discussionmentioning

confidence: 99%

Initial efficacy of a web-based alcohol and emotion regulation intervention for college women with sexual assault histories.

Stappenbeck¹,

Gulati²,

Jaffe³

et al. 2021

Psychology of Addictive Behaviors

View full text Add to dashboard Cite

show abstract

“…Using R statistical software, 1,000 data sets were generated based on the linear mixed models described below. Estimates for model parameters for standardized PTSD scores (e.g., baseline intercept, slopes for time, distribution of random effects) were guided by preliminary data from a prior trial (Simpson et al, 2022). We specified missingness of 13% and 19% at 3- and 6-month follow-ups, respectively, according to missing data patterns in similar studies (Walker et al, 2017).…”

Section: Methodsmentioning

confidence: 99%

Improving voluntary engagement for posttraumatic stress disorder treatment among active-duty service members using motivational enhancement therapy.

Walker,

Walton,

Jaffe

et al. 2024

Psychological Trauma: Theory, Research, Practice, and Policy

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Objective: Posttraumatic stress disorder (PTSD) prevalence in the military is high and effective treatments are underutilized. Motivational enhancement therapy (MET) “check-ups” are brief interventions to elicit treatment uptake for those who are nontreatment seeking. The aim of the current study was to test the efficacy of a novel MET intervention designed to promote treatment engagement among active-duty U.S. military personnel with untreated PTSD. Method: One hundred and sixty-one active-duty service members who met the criteria for PTSD were randomized to MET or treatment as usual (TAU, treatment resource and referral). MET participants (n = 82) received up to three 30–90 min telephone sessions. TAU participants (n = 79) were mailed PTSD resources and referrals. Follow-up assessments were conducted 6-week, 3- and 6-month postbaseline. Results: Mixed effect model results indicated treatment uptake significantly increased over time but there were no significant differences between conditions or interactions. PTSD symptom severity significantly decreased for both conditions. There was also a significant three-way interaction with baseline readiness-to-change confidence. Those low in baseline readiness-to-change saw more favorable effects of MET (relative to TAU) at 6-month follow-up. Conclusions: Results suggest both MET and high-quality referral options have promise as a means of increasing evidence-based treatment uptake and decreasing PTSD for service members with PTSD. MET may be particularly useful for individuals with low confidence in their ability to address PTSD. Given the individual and societal costs of PTSD, there is a need for interventions facilitating treatment uptake.

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“…For example, COPE (Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure) [25] and Seeking Safety [26] are effective integrated treatments for addressing traumatic stress and alcohol misuse simultaneously. In addition, traumatic stress treatment alone (ie, Cognitive Processing Therapy) has been shown to reduce alcohol and other substance use among survivors of SA [27]. Finally, a psychoeducational video shown to survivors of recent SA during a forensic examination was found to be an effective early intervention to reduce the risk of alcohol misuse among recent survivors with a previous history of exposure to SA [28].…”

Section: Mental Health Service Use For Traumatic Stress and Alcohol M...mentioning

confidence: 99%

Web-Based Screening, Brief Intervention, and Referral to Treatment for Traumatic Stress and Alcohol Misuse Among Survivors of Sexual Assault and Intimate Partner Violence: Usability and Acceptability Study

Hahn,

Tilstra-Ferrell,

Salim

et al. 2024

JMIR Form Res

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Background Recent survivors of intimate partner violence (IPV) and sexual assault (SA) are at a high risk for traumatic stress and alcohol misuse. IPV and SA survivors face barriers to services for traumatic stress and alcohol misuse and have low service utilization rates. One way to increase access to services for this population is the use of web-based screening, brief intervention, and referral to treatment (SBIRT), an evidence-informed approach for early identification of traumatic stress and alcohol and drug misuse and connecting individuals to treatment. Objective This study aims to assess the usability and acceptability of a web-based SBIRT called CHAT (Choices For Your Health After Trauma) tailored to address traumatic stress and alcohol misuse following past-year IPV, SA, or both. Methods Phase 1 involved gathering feedback about usability and acceptability from focus groups with victim service professionals (22/52, 42%) and interviews with past-year survivors of IPV, SA, or both (13/52, 25%). Phase 2 involved gathering feedback about the acceptability of an adapted version of CHAT in an additional sample of recent survivors (17/52, 33%). Survey data on history of IPV and SA, posttraumatic stress disorder symptoms, alcohol and drug use, and service use were collected from survivors in both phases to characterize the samples. Qualitative content and thematic analyses of the interviews and focus group data were conducted using a coding template analysis comprising 6 a priori themes (usability, visual design, user engagement, content, therapeutic persuasiveness, and therapeutic alliance). Results Six themes emerged during the focus groups and interviews related to CHAT: usability, visual design, user engagement, content, therapeutic persuasiveness, and therapeutic alliance. Phase 1 providers and survivors viewed CHAT as acceptable, easy to understand, and helpful. Participants reported that the intervention could facilitate higher engagement in this population as the web-based modality is anonymous, easily accessible, and brief. Participants offered helpful suggestions for improving CHAT by updating images, increasing content personalization, reducing text, and making users aware that the intervention is confidential. The recommendations of phase 1 participants were incorporated into CHAT. Phase 2 survivors viewed the revised intervention and found it highly acceptable (mean 4.1 out of 5, SD 1.29). A total of 4 themes encapsulated participant’s favorite aspects of CHAT: (1) content and features, (2) accessible and easy to use, (3) education, and (4) personalization. Six survivors denied disliking any aspect. The themes on recommended changes included content and features, brevity, personalization, and language access. Participants provided dissemination recommendations. Conclusions Overall, CHAT was acceptable among victim service professionals and survivors. Positive reactions to CHAT show promise for future research investigating the efficacy and potential benefit of CHAT when integrated into services for people with traumatic stress and alcohol misuse after recent IPV and SA.

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Cognitive Processing Therapy or Relapse Prevention for comorbid Posttraumatic Stress Disorder and Alcohol Use Disorder: A randomized clinical trial

Cited by 11 publications

References 67 publications

Initial efficacy of a web-based alcohol and emotion regulation intervention for college women with sexual assault histories.

Initial efficacy of a web-based alcohol and emotion regulation intervention for college women with sexual assault histories.

Improving voluntary engagement for posttraumatic stress disorder treatment among active-duty service members using motivational enhancement therapy.

Web-Based Screening, Brief Intervention, and Referral to Treatment for Traumatic Stress and Alcohol Misuse Among Survivors of Sexual Assault and Intimate Partner Violence: Usability and Acceptability Study

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