Drug use and validity of substance use self-reports in veterans seeking help for posttraumatic stress disorder.

Calhoun, Patrick S.; Sampson, William S.; Bosworth, Hayden B.; Feldman, Michelle E.; Kirby, Angela C.; Hertzberg, Michael A.; Wampler, Timothy P.; Tate-Williams, Faye; Moore, Scott D.; Beckham, Jean C.

doi:10.1037/0022-006x.68.5.923

Cited by 59 publications

(42 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Two studies examining self-reported substance use among patients with PTSD found participants' responses to be highly valid, with less than 10% of participants not reporting substance use detected by urine screens. 39,40 Second, although the effects observed remained after controlling for between-group differences in exposure to usual treatment and in the prevalence of childhood sexual abuse and childhood trauma, the outcomes observed may have been influenced by confounding factors not measured by the present study. It could also be argued that the differences observed may be attributed to more general therapist effects (ie, the treatment group received up to 13 sessions with a therapist that the control group did not).…”

Section: Commentcontrasting

confidence: 58%

Integrated Exposure-Based Therapy for Co-occurring Posttraumatic Stress Disorder and Substance Dependence

Mills

Teesson

Back

et al. 2012

JAMA

282

288

View full text Add to dashboard Cite

Context There is concern that exposure therapy, an evidence-based cognitivebehavioral treatment for posttraumatic stress disorder (PTSD), may be inappropriate because of risk of relapse for patients with co-occurring substance dependence.Objective To determine whether an integrated treatment for PTSD and substance dependence, Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE), can achieve greater reductions in PTSD and substance dependence symptom severity compared with usual treatment for substance dependence.Design, Setting, and Participants Randomized controlled trial enrolling 103 participants who met DSM-IV-TR criteria for both PTSD and substance dependence. Participants were recruited from 2007-2009 in Sydney, Australia; outcomes were assessed at 9 months postbaseline, with interim measures collected at 6 weeks and 3 months postbaseline.Interventions Participants were randomized to receive COPE plus usual treatment (n=55) or usual treatment alone (control) (n=48). COPE consists of 13 individual 90minute sessions (ie, 19.5 hours) with a clinical psychologist. Main Outcome MeasuresChange in PTSD symptom severity as measured by the Clinician-Administered PTSD Scale (CAPS; scale range, 0-240) and change in severity of substance dependence as measured by the number of dependence criteria met according to the Composite International Diagnostic Interview version 3.0 (CIDI; range, 0-7), from baseline to 9-month follow-up. A change of 15 points on the CAPS scale and 1 dependence criterion on the CIDI were considered clinically significant. ResultsFrom baseline to 9-month follow-up, significant reductions in PTSD symptom severity were found for both the treatment group (mean difference, −38.24 [95% CI, −47.93 to −28.54]) and the control group (mean difference, −22.14 [95% CI, −30.33 to −13.95]); however,thetreatmentgroupdemonstratedasignificantlygreaterreductioninPTSDsymptom severity (mean difference, −16.09 [95% CI, −29.00 to −3.19]). No significant between-group difference was found in relation to improvement in severity of substance dependence (0.43 vs 0.52; incidence rate ratio, 0.85 [95% CI, 0.60 to 1.21), nor were there any significant between-group differences in relation to changes in substance use, depression, or anxiety. ConclusionAmong patients with PTSD and substance dependence, the combined use of COPE plus usual treatment, compared with usual treatment alone, resulted in improvement in PTSD symptom severity without an increase in severity of substance dependence.

show abstract

Section: Commentcontrasting

confidence: 58%

Integrated Exposure-Based Therapy for Co-occurring Posttraumatic Stress Disorder and Substance Dependence

Mills

Teesson

Back

et al. 2012

JAMA

282

288

View full text Add to dashboard Cite

show abstract

“…Objective measures of symptom severity may be particularly useful in PTSD populations where the validity of self-report is often questioned due to issues associated with secondary gain (Calhoun et al, 2000) and negative cognitive biases (Buckley et al, 2000). Further, assessing patients in their home environment avoids the effects of reactivity to the laboratory environment.…”

Section: Discussionmentioning

confidence: 99%

Objective evidence of sleep disturbance in women with posttraumatic stress disorder

Calhoun

Wiley

Dennis

et al. 2007

Journal of Traumatic Stress

Self Cite

View full text Add to dashboard Cite

Although sleep disturbance is considered a hallmark of posttraumatic stress disorder (PTSD), objective evidence for sleep disturbance in patients with PTSD has been equivocal. The goal of the current investigation was to objectively examine sleep disturbance among women with PTSD in their home environment. Women with PTSD (n = 30) and a control group (n = 22) completed three nights of actigraphy monitoring. Results from actigraphy indicated that women with PTSD had poorer sleep efficiency, increased sleep latency, and more restless sleep. Actigraphy measures were moderately correlated with self-report sleep-log data, but were unrelated to scores on the Pittsburgh Sleep Quality Index. The current study provides evidence that women with PTSD have objectively measured sleep disturbance in their normal environment at home. Disturbed sleep may have important implications for the health and well-being of individuals with PTSD.

show abstract

“…Although clinical studies have not yet investigated interactions between these two stress systems, recent findings indicate that administration of the synthetic cannabinoid nabilone to PTSD patients resulted in a highly comparable reduction of treatment-resistant daytime flashbacks and nightmares (56). Moreover, PTSD is often associated with high levels of cannabis consumption (57), which might be related, in part, to an inadequate activation of the endogenous GC and endocannabinoid systems in these patients (58). Furthermore, based on our finding that systemic CORT administration impaired the retrieval of hippocampus-dependent contextual fear memory without affecting the retrieval of hippocampus-independent auditory fear memory, it would seem important to also investigate whether GC or cannabinoid administration might selectively reduce the retrieval of hippocampus-dependent traumatic memories in PTSD patients.…”

Section: Discussionmentioning

confidence: 99%

Glucocorticoids interact with the hippocampal endocannabinoid system in impairing retrieval of contextual fear memory

Atsak

Hauer

Campolongo

et al. 2012

Proc. Natl. Acad. Sci. U.S.A.

123

View full text Add to dashboard Cite

There is extensive evidence that glucocorticoid hormones impair the retrieval of memory of emotionally arousing experiences. Although it is known that glucocorticoid effects on memory retrieval impairment depend on rapid interactions with arousalinduced noradrenergic activity, the exact mechanism underlying this presumably nongenomically mediated glucocorticoid action remains to be elucidated. Here, we show that the hippocampal endocannabinoid system, a rapidly activated retrograde messenger system, is involved in mediating glucocorticoid effects on retrieval of contextual fear memory. Systemic administration of corticosterone (0.3-3 mg/kg) to male Sprague-Dawley rats 1 h before retention testing impaired the retrieval of contextual fear memory without impairing the retrieval of auditory fear memory or directly affecting the expression of freezing behavior. Importantly, a blockade of hippocampal CB1 receptors with AM251 prevented the impairing effect of corticosterone on retrieval of contextual fear memory, whereas the same impairing dose of corticosterone increased hippocampal levels of the endocannabinoid 2-arachidonoylglycerol. We also found that antagonism of hippocampal β-adrenoceptor activity with local infusions of propranolol blocked the memory retrieval impairment induced by the CB receptor agonist WIN55,212-2. Thus, these findings strongly suggest that the endocannabinoid system plays an intermediary role in regulating rapid glucocorticoid effects on noradrenergic activity in impairing memory retrieval of emotionally arousing experiences.cannabinoid receptor | norepinephrine | emotional arousal | fear conditioning | posttraumatic stress disorder I t is well-established that glucocorticoid (GC) hormones, released from the adrenal cortex during stressful episodes, can modulate different memory processes (1-4). Although most studies focused on GC effects on the acquisition and consolidation of memory, extensive evidence also indicates that acutely elevated GC levels at the time of retention testing impair the retrieval of memory of spatial and contextual training (5-9). Because a glucocorticoid receptor (GR) agonist infused into the hippocampus before retention induces comparable memory retrieval impairment (10, 11), such findings suggest that GC effects on memory retrieval depend, at least in part, on activation of GRs in the hippocampus. Findings of studies of human subjects are consistent with the findings of animal studies and indicate that exogenous GC administration or exposure to a psychosocial stressor shortly before retention testing impairs retrieval of declarative (mostly episodic) information (7, 12, 13) and reduces hippocampal activity (14). Moreover, previous findings indicate that emotionally arousing information is especially sensitive to the retrieval-impairing effects of GCs (8) and that emotional arousal during the test situation enables GC effects on memory retrieval (15). Findings of recent clinical studies suggest that the administration of stress doses of GCs may have therapeutic v...

show abstract

Drug use and validity of substance use self-reports in veterans seeking help for posttraumatic stress disorder.

Cited by 59 publications

References 32 publications

Integrated Exposure-Based Therapy for Co-occurring Posttraumatic Stress Disorder and Substance Dependence

Integrated Exposure-Based Therapy for Co-occurring Posttraumatic Stress Disorder and Substance Dependence

Objective evidence of sleep disturbance in women with posttraumatic stress disorder

Glucocorticoids interact with the hippocampal endocannabinoid system in impairing retrieval of contextual fear memory

Contact Info

Product

Resources

About