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Behav Res Ther. 2017 Mar;90:9-15. doi: 10.1016/j.brat.2016.11.013. Epub 2016 Nov 24.

Changes in coping behavior in a randomized controlled trial of concurrent treatment for PTSD and alcohol dependence.

Author information

1
University of Pennsylvania, Philadelphia, PA, USA. Electronic address: yinyinz@mail.med.upenn.edu.
2
Rutgers, The State University of New Jersey, Piscataway, NJ, USA.
3
University of Pennsylvania, Philadelphia, PA, USA.

Abstract

OBJECTIVE:

The current study examines changes in coping among 165 adults meeting DSM-IV criteria for co-morbid posttraumatic stress disorder (PTSD) and alcohol dependence (AD).

METHOD:

Participants were randomized to receive naltrexone or placebo, with or without prolonged exposure (PE). All participants received supportive counseling focused on alcohol use (BRENDA). Assessments of coping, PTSD, and AD were conducted at pre-treatment, mid-treatment, post-treatment, 3-month follow-up, and 6-month follow-up.

RESULTS:

Participants exhibited significant decreases in both avoidant coping and adaptive coping from pre-treatment to 6-month follow-up across all groups. Participants who received PE showed faster decreases in avoidant coping during this period than participants who did not receive PE. PTSD symptom reduction was associated with changes in both avoidant and adaptive coping across groups. Improvement in PTSD symptoms was related to a faster rate of reduction in avoidant coping in the PE groups compared to those receiving BRENDA alone.

CONCLUSIONS:

The current results suggest that concurrent treatment for co-morbid PTSD-AD decreases avoidant and adaptive coping, and participants who show greater reductions in PTSD symptoms also show greater changes in coping style. Consistent with theorized mechanisms of change in PE, the addition of PE to supportive counseling for AD was associated with a greater reduction of avoidant coping than supportive counseling alone.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00006489.

KEYWORDS:

Alcohol dependence; Coping; Naltrexone; PTSD; Prolonged exposure; Substance use disorder

PMID:
27930926
DOI:
10.1016/j.brat.2016.11.013
[Indexed for MEDLINE]

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