Suicidal Thoughts and Behaviors Do Not Influence Veterans' Alcohol Use Disorder or Posttraumatic Stress Disorder Recovery Trajectories in a Randomized Controlled Trial

Suicidal thoughts and behaviors (STB) are elevated among individuals with alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD). The highest STB prevalences occur among those with comorbid AUD-PTSD. STB interferes with AUD and PTSD recovery outcomes. However, no research has examined the impact of STB on recovery trajectories among those with dual AUD-PTSD, a comorbidity with a chronic and difficult-to-treat clinical profile.

Data from a randomized controlled trial with 141 (84.4% male) treatment-seeking Veterans with comorbid AUD-PTSD were used to compare the 12-week recovery trajectories for alcohol consumption (percent drinking days; percent heavy drinking days) and PTSD symptoms between the following groups: (a) Veterans with (n = 90) versus without (n = 51) lifetime STB and (b) Veterans with (n = 46) versus without (n = 95) current STB.

Compared to respective groups without STB, Veterans with lifetime and current STB had similar severity of drinking consumption over 12 weeks and similar reductions in drinking consumption and PTSD symptoms over the study period. Veterans with (vs. without) current STB reported significantly higher PTSD symptom levels throughout the 12 weeks.

Results suggest that the presence of lifetime and current STB does increase the severity of PTSD but does not appear to impact the rates of symptom recovery across a 12-week period. Results provide important context for cross-sectional research, underscoring the greater severity of AUD-PTSD. Our longitudinal analyses indicate that Veterans can achieve symptom improvements in AUD and PTSD, even in the context of co-occurring STB.