Category: Adult Anxiety
Keywords: Treatment Integrity / Adherence / Compliance | Substance Abuse | PTSD
Presentation Type: Symposium
The present study examined attendance patterns in a randomized clinical trial (N=82) comparing Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE) with Relapse Prevention Therapy (RPT). Latent class growth analysis (LCGA) tested whether intervention attendance would be better modeled as qualitatively distinct attendance patterns rather than as a single mean pattern. Generalized linear mixed modeling (GLMM) was used to examine baseline predictors of attendance, and differences in treatment response among attendance patterns. The LCGA solution with three patterns characterized by high probability of attendance throughout (Completers, 36.6%), gradual decreasing probability of attendance (Titrators, 31.7%), and high probability of dropout within the first few weeks (Droppers, 31.6%) provided the best fit. Baseline MDD diagnosis was associated with greater odds of titrating rather than completing, and multiple trauma was associated with greater odds of titrating rather than dropping. Titrators showed faster improvement in PTSD symptoms in the first half of treatment relative to Completers, but similar rates of reduction in days of substance use. These findings underscore the utility of taking a person-centered approach to examining treatment attendance. While the empirically-derived patterns of completion, titration, and dropping are ecologically intuitive, unexpected relationships among attendance patterns, baseline variables, and treatment response emerged, suggesting that treatment titration may represent self-modulation of dosage.
University of Texas
Saturday, November 18
12:00 PM – 1:30 PM
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