VA Boston Healthcare System, 150 South Huntington Ave., 116-B, Boston, MA 02130, USA.
J Clin Psychol. 2013 May;69(5):433-79. doi: 10.1002/jclp.21980.
We review treatment studies for comorbid substance use disorder (SUD) and posttraumatic stress disorder (PTSD). Results show positive outcomes on multiple domains. Most models had more effect on PTSD than SUD, suggesting SUD is harder to treat. Seeking Safety (SS) is the most studied model. It shows positive outcomes, and is the only treatment outperforming a control on both PTSD and SUD. Partial-dose SS had more mixed results than the full dose. This first-generation of PTSD/SUD research addresses complex samples excluded from "gold standard" PTSD-alone literature. Treatments for PTSD/SUD are generally longer than PTSD-alone treatments and present-focused, emphasizing stabilization and coping. The few models with past-focused (exposure-based) components also incorporated present-focused approaches for these vulnerable clients. We discuss public health perspectives to advance the field.
我们回顾了治疗共病物质使用障碍（SUD）和创伤后应激障碍（PTSD）的研究。结果表明，在多个领域都取得了积极的结果。大多数模型对 PTSD 的影响大于 SUD，这表明 SUD 更难治疗。寻求安全（SS）是研究最多的模型。它显示出积极的结果，并且是唯一一种在 PTSD 和 SUD 上都优于对照的治疗方法。部分剂量的 SS 比全剂量的 SS 结果更为复杂。这第一代 PTSD/SUD 研究解决了复杂的样本，这些样本被排除在“黄金标准”的 PTSD 单一文献之外。治疗 PTSD/SUD 的时间通常比治疗 PTSD 单独的时间长，以现在为重点，强调稳定和应对。少数具有过去为重点（基于暴露的）成分的模型也为这些脆弱的客户纳入了以现在为重点的方法。我们讨论了推进该领域的公共卫生观点。
