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Subject: LCSH

Veterans, Post-traumatic stress disorder, Substance use




Substantial rates of substance use comorbidity have been observed among veterans with PTSD highlighting the need to identify patient and program characteristics associated with improved outcomes for substance abuse. Data were drawn from 12,270 dually diagnosed veterans who sought treatment from specialized intensive Veterans Health Administration PTSD programs between 1993 and 2011. The magnitude of the improvement in Addiction Severity Index (ASI) alcohol and drug use composite scores from baseline was moderate, with effect sizes (ES) of -.269 and -.287, respectively. Multivariate analyses revealed that treatment in longer-term programs, being prescribed psychiatric medication, and planned participation in reunions were all associated with slightly improved outcomes. Reductions in substance use measures were associated with robust improvements in PTSD symptoms and violent behavior. These findings suggest not only synergistic treatment effects linking improvement in PTSD symptoms with substance use disorders among dually diagnosed veterans with PTSD but also to improvement in violent behavior. Furthermore, the findings indicate that proper discharge planning in addition to intensity and duration of treatment for dually diagnosed veterans with severe PTSD may result in better outcomes. Further dissemination of evidence-based substance abuse treatment may benefit this population.


© 2016 American Psychological Association. This is the author's accepted manuscript of the article published in Psychological Trauma. This article may not exactly replicate the authoritative document published in the APA journal. It is not the copy of record. The published article may be found at .



Publisher Citation

Correlates of improvement in substance abuse among dually diagnosed veterans with post-traumatic stress disorder in specialized intensive VA treatment. Coker KL, Stefanovics E, Rosenheck R. Psychol Trauma. 2016 Jan;8(1):41-8. doi: 10.1037/tra0000061. Epub 2015 Jun 29.

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