Pre-treatment predictors of dropout from prolonged exposure therapy in patients with chronic posttraumatic stress disorder and comorbid substance use disorders

Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) are commonly co-occurring disorders associated with more adverse consequences than PTSD alone. Prolonged exposure therapy (PE) is one of the most efficacious treatments for PTSD. However, among individuals with PTSD-SUD, 35–62%...

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Bibliographic Details
Published in:Behaviour research and therapy Vol. 91; pp. 43 - 50
Main Authors: Belleau, Emily L., Chin, Eu Gene, Wanklyn, Sonya G., Zambrano-Vazquez, Laura, Schumacher, Julie A., Coffey, Scott F.
Format: Journal Article
Language:English
Published: England Elsevier Ltd 01.04.2017
Elsevier Science Ltd
Subjects:
Abusers
Adjustment
Adult
Alcoholism - epidemiology
Alcoholism - psychology
Alcoholism - therapy
Anxiety
Clinical outcomes
Clinical trials
Cognitive ability
Comorbidity
Disorders
Dropout
Dropping out
Drug abuse
Education
Emotional regulation
Emotions
Exposure therapy
Female
Flexibility
Humans
Implosive Therapy - statistics & numerical data
Male
Medical treatment
Mental disorders
Mental health
Patient Dropouts - psychology
Patients
Post traumatic stress disorder
Posttraumatic stress
Prolonged exposure
Residential treatment
Retention
Risk Factors
Sensitivity
Severity
Social anxiety
Social interactions
Stress Disorders, Post-Traumatic - epidemiology
Stress Disorders, Post-Traumatic - psychology
Stress Disorders, Post-Traumatic - therapy
Substance abuse
Substance abuse treatment
Substance use
Substance use disorder
Termination
Therapy
Trauma
Treatment methods
Treatment Outcome
Treatment programs
Treatment termination
United States - epidemiology
Young Adult
Substance use
Posttraumatic stress
Prolonged exposure
Treatment termination
Dropout
ISSN:0005-7967, 1873-622X, 1873-622X
Online Access:Get full text
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Summary:Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) are commonly co-occurring disorders associated with more adverse consequences than PTSD alone. Prolonged exposure therapy (PE) is one of the most efficacious treatments for PTSD. However, among individuals with PTSD-SUD, 35–62% of individuals drop out of trauma-focused exposure treatments. Thus, it is important to identify predictors of PTSD treatment dropout among substance abusers with PTSD in order to gain information about adapting treatment strategies to enhance retention and outcomes. The current study explored pre-treatment predictors of early termination from PE treatment in a sample of 85 individuals receiving concurrent treatment for PTSD and a SUD in a residential treatment facility as part of a randomized controlled trial. The results indicated that less education and more anxiety sensitivity uniquely predicted PE treatment dropout. Demographic variables, PTSD severity, SUD severity, mental health comorbidities, and emotion regulation difficulties did not predict treatment dropout. These results suggest that adding pre-treatment interventions that address anxiety sensitivity, and promote social adjustment and cognitive flexibility, could possibly improve PE retention rates in clients with high anxiety or low education. •Examined predictors of exposure treatment termination in those with PTSD and SUD.•Lower levels of education uniquely predicted earlier treatment termination.•Higher anxiety sensitivity uniquely predicted earlier treatment termination.
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ISSN:0005-7967
1873-622X
1873-622X
DOI:10.1016/j.brat.2017.01.011