A multisite randomized controlled trial of Seeking Safety vs. Relapse Prevention Training for women with co-occurring posttraumatic stress disorder and substance use disorders. Issue 1 (1st January 2019)

• Record Type: Journal Article
• Authors: Schäfer, Ingo; Lotzin, Annett; Hiller, Philipp; Sehner, Susanne; Driessen, Martin; Hillemacher, Thomas; Schäfer, Martin; Scherbaum, Norbert; Schneider, Barbara; Grundmann, Johanna
• Is Part Of: European journal of psychotraumatology. Volume 10:Issue 1(2019)
• Publication Date: 2019-01-01
• Subjects: Posttraumatic stress disorder -- substance use disorder -- dual diagnosis -- trauma -- addiction -- alcohol abuse -- drug abuse -- randomized controlled trial -- Seeking Safety -- relapse prevention; Trastorno de Estrés Postraumático -- Trastorno por Uso de Sustancias -- Diagnostico Dual -- Trauma -- Adicción -- abuso de Alcohol -- abuso de drogas -- Ensayo controlado aleatorio -- Búsqueda de Seguridad -- Prevención de Recaídas.; 创伤后应激障碍 -- 物质使用障碍 -- 双重诊断 -- 创伤 -- 成瘾 -- 酒精滥用 -- 药物滥用 -- 随机对照试验 -- 寻求安全 -- 复发预防; We compared a treatment programme for co-occurring PTSD and substance use disorders (Seeking Safety) to another cognitive behavioural treatment (Relapse Prevention Training) and to treatment as usual (TAU).Decreases in PTSD severity were comparable in all three conditions. The Seeking Safety group improved more on depression and emotion regulation than TAU alone. The Relapse Prevention group improved more on alcohol and drug use than TAU alone.; Post-traumatic stress disorder -- Periodicals; Stress Disorders, Post-Traumatic; Post-traumatic stress disorder; Electronic journals; Periodicals; Periodicals; Fulltext; Internet Resources; Periodicals; 616.8521
• DOI: 10.1080/20008198.2019.1577092
• Languages: English
• ISSNs: 2000-8198

Abstract

ABSTRACT: Background : Co-occurring posttraumatic stress disorder (PTSD) and substance use disorders (SUD) are associated with a more severe course and worse outcome than either disorder alone. In Europe, few treatments have been evaluated for PTSD and SUD. Seeking Safety, a manualized, integrated, cognitive-behavioural treatment, has been shown to be effective in studies in the USA. Objective : To test the efficacy of Seeking Safety plus treatment as usual (TAU) in female outpatients with PTSD and SUD compared to Relapse Prevention Training (RPT) plus TAU and TAU alone. Method : In five German study centres a total of N = 343 women were randomized into one of the three study conditions. PTSD severity (primary outcome), substance use, depression and emotion dysregulation (secondary outcomes) were assessed at baseline, post-treatment, as well as at three months and six months post-treatment. Results : Treatment participants attended M = 6.6 sessions (Seeking Safety) and M = 6.1 sessions (RPT). In an intent-to-treat analysis, Seeking Safety plus TAU, RPT plus TAU and TAU alone showed comparable decreases in PTSD severity over the course of the study. Seeking Safety plus TAU showed superior efficacy to TAU alone on depression and emotion regulation and RPT plus TAU was more effective than TAU alone on number of substance-free days and alcohol severity. Minimum-dose analyses suggest additional effects of both programmes among participants who attended at least eight group sessions. Conclusions : With respect to PTSD symptoms, a brief dose of Seeking Safety and RPT in addition to TAU was not superior to TAU alone in women with PTSD and SUD. However, Seeking Safety and RPT showed greater reductions than TAU alone in other domains of psychopathology and substance use outcomes respectively. Future studies should investigate further variables, such as what aspects of each treatment appeal to particular patients and how best to disseminate them.