Straud Casey L, Buccellato Kiara H, Foa Edna B, Brown Lily A, McLean Carmen P, Blount Tabatha H, Schobitz Richard P, DeBeer Bryann B, Mignogna Joseph, Fina Brooke A, Hall-Clark Brittany N, Schrader Christian C, Yarvis Jeffrey S, Jacoby Vanessa M, Evans Wyatt R, Litz Brett T, Meyer Eric C, Niles Barbara L, Young-McCaughan Stacey, Keane Terence M, Peterson Alan L
Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
Department of Psychology, University of Texas at San Antonio, San Antonio, TX 78249, USA.
Behav Sci (Basel). 2025 Jul 15;15(7):954. doi: 10.3390/bs15070954.
Individuals with post-traumatic stress disorder (PTSD) are at increased risk for hazardous drinking, which often complicates treatment and affects trauma-focused psychotherapy outcomes. The present study is an exploratory, secondary analysis investigating differential effects of prolonged exposure (PE) among those with and without hazardous drinking and whether treatment outcomes varied across these groups as a function of PE format. Data used were from a randomized controlled trial that examined two daily, compressed formats of PE treatment for PTSD (massed and intensive outpatient program) in military personnel and veterans (N = 234). Individuals without hazardous drinking had greater PTSD symptom reductions compared to those with hazardous drinking ( = 0.42, = 0.001). However, the hazardous drinking group also demonstrated significant reductions in PTSD ( = 1.46, < 0.001) following treatment, as well as in the number of drinks per week ( = 0.63, = 0.025) at the 6-month follow-up. There was no significant difference in treatment engagement based on drinking classification and outcomes did not vary based on PE format. The findings suggest that PE is an appropriate treatment for individuals with PTSD and hazardous drinking. However, group differences in PTSD symptom reductions indicate concurrent hazardous drinking reduces treatment benefits of PE.
患有创伤后应激障碍（PTSD）的个体出现危险饮酒行为的风险增加，这常常使治疗变得复杂，并影响以创伤为重点的心理治疗效果。本研究是一项探索性的二次分析，旨在调查有危险饮酒行为和无危险饮酒行为的个体在接受延长暴露疗法（PE）时的不同效果，以及这些组别的治疗结果是否因PE形式的不同而有所差异。所使用的数据来自一项随机对照试验，该试验在军事人员和退伍军人（N = 234）中检验了两种每日压缩形式的PTSD的PE治疗（集中式和强化门诊项目）。与有危险饮酒行为的个体相比，无危险饮酒行为的个体的PTSD症状减轻程度更大（ = 0.42， = 0.001）。然而，有危险饮酒行为的组在治疗后PTSD也有显著减轻（ = 1.46， < 0.001），并且在6个月随访时每周饮酒量也有所减少（ = 0.63， = 0.025）。基于饮酒分类的治疗参与度没有显著差异，并且结果也不因PE形式而有所不同。研究结果表明，PE是治疗患有PTSD和危险饮酒行为个体的一种合适疗法。然而，PTSD症状减轻方面的组间差异表明，同时存在的危险饮酒行为会降低PE的治疗效果。
