Cognitive Processing Therapy or Relapse Prevention for comorbid Posttraumatic Stress Disorder and Alcohol Use...

Area of Science:

• Psychiatry
• Addiction Medicine
• Clinical Psychology

Background:

• Comorbidity of Posttraumatic Stress Disorder (PTSD) and Alcohol Use Disorder (AUD) presents complex treatment challenges.
• Existing treatments may not adequately address both conditions simultaneously.

Purpose of the Study:

• To compare the efficacy of Cognitive Processing Therapy (CPT) for PTSD, Relapse Prevention (RP) for AUD, and assessment-only (AO) in patients with comorbid PTSD and AUD.
• To evaluate the impact of targeted treatments on both PTSD symptom severity and alcohol use outcomes.

Main Methods:

• 101 participants with current PTSD/AUD were randomized to CPT, RP, or AO.
• Assessment occurred post-treatment (CPT/RP) or 6-weeks post-randomization (AO).
• AO participants were re-randomized to CPT or RP; follow-ups were at 3 and 12 months.

Main Results:

• CPT significantly improved PTSD symptom severity compared to AO.
• Both CPT and RP significantly reduced heavy drinking days compared to AO.
• Following re-randomization, both treatments showed sustained improvements in PTSD and drinking over 12 months, with RP showing an advantage in reducing heavy drinking days.

Conclusions:

• Treatments targeting either PTSD or AUD can positively impact both conditions in comorbid patients.
• Individuals with PTSD/AUD comorbidity have effective treatment options available, regardless of their initial point of care (mental health or addiction services).