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The Impact of Hazardous Drinking Among Active Duty Military With Posttraumatic Stress Disorder: Does Cognitive Processing Therapy Format Matter?
Author(s) -
Straud Casey L.,
Dondanville Katherine A.,
Hale Willie J.,
Wachen Jennifer S.,
Mintz Jim,
Litz Brett T.,
Roache John D.,
Yarvis Jeffrey S.,
YoungMcCaughan Stacey,
Peterson Alan L.,
Resick Patricia A.
Publication year - 2021
Publication title -
journal of traumatic stress
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.259
H-Index - 134
eISSN - 1573-6598
pISSN - 0894-9867
DOI - 10.1002/jts.22609
Subject(s) - alcohol use disorders identification test , psychiatry , alcohol use disorder , cognitive processing therapy , randomized controlled trial , psychology , alcohol abuse , poison control , clinical psychology , cognitive therapy , cognition , injury prevention , medicine , alcohol , environmental health , biochemistry , chemistry
This study was a secondary data analysis of clinical trial data collected from 268 active duty U.S. military service members seeking cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) at Fort Hood, Texas, related to combat operations following September 11, 2001. Our primary aim was to evaluate changes in PTSD symptom severity and alcohol misuse as a function of baseline hazardous drinking and treatment format (i.e., group or individual). At baseline and posttreatment, PTSD was assessed using the PTSD Symptom Scale–Interview Version and PTSD Checklist for DSM‐5 . Hazardous drinking was categorically defined as an Alcohol Use Disorder Identification Test total score of 8 or higher. Employing intent‐to‐treat, mixed‐effects regression analysis, all groups reported reduced PTSD symptom severity, Hedges’ g s = −0.33 to −1.01, except, unexpectedly, nonhazardous drinkers who were randomized to group CPT, Hedges’ g = −0.12. Hazardous drinkers who were randomized to individual therapy had larger reductions in PTSD symptoms than nonhazardous drinkers who were randomized to group CPT, Hedges’ g = −0.25. Hazardous drinkers also reported significant reductions in alcohol misuse, regardless of treatment format, Hedges’ g s = −0.78 to −0.86. This study builds upon an emerging literature suggesting that individuals with PTSD and co‐occurring alcohol use disorder can engage successfully in CPT, which appears to be an appropriate treatment for these individuals whether it is delivered individually or in a group format. However, as a portion of participants remained classified as hazardous drinkers at posttreatment, some individuals may benefit from integrated treatment.