Individuals with comorbid posttraumatic stress disorder (PTSD) and alcohol/substance use disorder (A/SUD) who receive PTSD treatment are less likely to relapse when compared to those who do not; however, relapse rates remain high. The goal of this study was to better understand the relationship between posttraumatic distress (i.e., PTSD symptoms, depression symptoms, guilt) and relapse following A/SUD and PTSD treatment. Participants were 50 veterans who completed a PTSD track within a residential SUD treatment program. Participants completed self-report measures at entry into the program, discharge, and at three month follow up. Four measures of relapse at three-month follow-up were considered (derived from the Brief Addiction Monitor): (1) any illicit drug use (general), (2) any alcohol use, (3) illicit drug use (specific), and (4) binge drinking. Results from logistic regressions indicated that PTSD symptoms, depression symptoms, and guilt at both baseline and discharge were unrelated to all indicators of relapse at three-month follow-up. Likewise, changes in PTSD symptoms, depression, and guilt from baseline to discharge were also unrelated to relapse. Findings suggest that the importance of examining factors other than mental health symptoms that may influence relapse following residential PTSD/SUD treatment. Further assessment of physical health factors (e.g., pain); environmental factors (e.g., continued engagement in PTSD and/or SUD treatment as an outpatient, recovery home placement); factors of psychosocial functioning (e.g., engagement in work and/or school, responsibility of a child/family member); and social support factors (e.g., intimate relationships, friendships) should be considered in the future when understanding relapse in this population.
Brittany Davis– Clinical Psychologist, James A. Haley Veteran's Hospital, Tampa, Florida
Moira Haller– Assistant Clinical Professor, University of California, San Diego
Peter Colvonen– University of California, San Diego
Sonya Norman– Director, PTSD Mentoring Program / Professor, Department of Psychiatry, National Center for PTSD; Center of Excellence for Stress and Mental Health and VA San Diego Healthcare, San Diego, California