Integrated Alcohol Disorder and PTSD Treatment
Condition: PTSD; Alcoholism
MeSH terms: Alcoholism; Alcohol-Related Disorders
Intervention: Integrated Prolonged Exposure Therapy; Seeking Safety
Intervention description: Prolonged exposure (PE) therapy is an evidence based practice for the treatment of PTSD. Components of PE included education about PTSD and exposure to avoided reminders of trauma.; Seeking Safety (SS) teaching coping skills in behavioral, cognitive, and interpersonal domains so that people are able to make safe choices rather than drinking or PTSD-related behaviors such as avoidance.
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Enrollment: 168.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No
Keywords: posttraumatic stress disorder; psychotherapy; alcoholism

Summary:

      Comorbidity of alcohol use disorder (AD) and posttraumatic stress disorder (PTSD) is common.
      Currently available treatments often do not lead to sustained recovery from these disorders,
      possibly because they typically do not include exposure therapy which is considered best
      practice treatments for PTSD. This study compares exposure-based integrated treatment to
      integrated coping skills psychotherapy (a well disseminated practice) for comorbid AD and
      PTSD with the hypothesis that exposure therapy will allow those with PTSD to better sustain
      PTSD symptom reduction and reduction in alcohol use. The aim of this grant is to change
      common treatment practices for comorbid AD and PTSD by increasing the availability of
      evidence-based PTSD treatment for those with AD.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Veterans who were victims of psychological trauma that occurred in childhood or
             adulthood.

          -  At least one month post-trauma.

          -  Age 18 or older.

          -  Meeting diagnostic criteria for current alcohol dependence and PTSD.

          -  Literate in English.

          -  Intend to stay in San Diego during study participation.

          -  Willing to attend psychotherapy and measurement sessions.

          -  Willing to stay cut down alcohol use significantly during treatment.

        Exclusion Criteria:

          -  Moderate or severe cognitive impairment on the Brief Neuropsychological (NP)
             Assessment Battery as this may interfere with ability to benefit from treatment.

          -  Acutely suicidal individuals will be referred for more appropriate treatment.

          -  Histories of psychosis or mania independent of substance use will be excluded because
             the presence of these disorders can impede therapy progress.

          -  Individuals who use intravenous drugs will be excluded.

          -  Participants who do not have adequate memory of the trauma will be excluded because
             such memory is necessary for exposure therapy.

          -  Only Veterans residing within 50 miles of the site will be included.

          -  Those with life threatening or unstable medical illness, documented neurological
             disorder, or inability to read will be excluded.