Differential Effects of Hazardous Drinking on Post-Traumatic Stress Disorder Outcomes Across Two Prolonged Exposure Treatment Formats

Individuals with post-traumatic stress disorder (PTSD) are at increased risk for hazardous drinking, which often complicates treatment and affects trauma-focused psychotherapy outcomes. The present study is an exploratory, secondary analysis investigating differential effects of prolonged exposure (...

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Main Authors: Casey L. Straud, Kiara H. Buccellato, Edna B. Foa, Lily A. Brown, Carmen P. McLean, Tabatha H. Blount, Richard P. Schobitz, Bryann B. DeBeer, Joseph Mignogna, Brooke A. Fina, Brittany N. Hall-Clark, Christian C. Schrader, Jeffrey S. Yarvis, Vanessa M. Jacoby, Wyatt R. Evans, Brett T. Litz, Eric C. Meyer, Barbara L. Niles, Stacey Young-McCaughan, Terence M. Keane, Alan L. Peterson
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Behavioral Sciences
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Online Access:https://www.mdpi.com/2076-328X/15/7/954
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author Casey L. Straud
Kiara H. Buccellato
Edna B. Foa
Lily A. Brown
Carmen P. McLean
Tabatha H. Blount
Richard P. Schobitz
Bryann B. DeBeer
Joseph Mignogna
Brooke A. Fina
Brittany N. Hall-Clark
Christian C. Schrader
Jeffrey S. Yarvis
Vanessa M. Jacoby
Wyatt R. Evans
Brett T. Litz
Eric C. Meyer
Barbara L. Niles
Stacey Young-McCaughan
Terence M. Keane
Alan L. Peterson
author_facet Casey L. Straud
Kiara H. Buccellato
Edna B. Foa
Lily A. Brown
Carmen P. McLean
Tabatha H. Blount
Richard P. Schobitz
Bryann B. DeBeer
Joseph Mignogna
Brooke A. Fina
Brittany N. Hall-Clark
Christian C. Schrader
Jeffrey S. Yarvis
Vanessa M. Jacoby
Wyatt R. Evans
Brett T. Litz
Eric C. Meyer
Barbara L. Niles
Stacey Young-McCaughan
Terence M. Keane
Alan L. Peterson
author_sort Casey L. Straud
collection DOAJ
description Individuals with post-traumatic stress disorder (PTSD) are at increased risk for hazardous drinking, which often complicates treatment and affects trauma-focused psychotherapy outcomes. The present study is an exploratory, secondary analysis investigating differential effects of prolonged exposure (PE) among those with and without hazardous drinking and whether treatment outcomes varied across these groups as a function of PE format. Data used were from a randomized controlled trial that examined two daily, compressed formats of PE treatment for PTSD (massed and intensive outpatient program) in military personnel and veterans (N = 234). Individuals without hazardous drinking had greater PTSD symptom reductions compared to those with hazardous drinking (<i>d</i> = 0.42, <i>p</i> = 0.001). However, the hazardous drinking group also demonstrated significant reductions in PTSD (<i>d</i> = 1.46, <i>p</i> < 0.001) following treatment, as well as in the number of drinks per week (<i>d</i> = 0.63, <i>p</i> = 0.025) at the 6-month follow-up. There was no significant difference in treatment engagement based on drinking classification and outcomes did not vary based on PE format. The findings suggest that PE is an appropriate treatment for individuals with PTSD and hazardous drinking. However, group differences in PTSD symptom reductions indicate concurrent hazardous drinking reduces treatment benefits of PE.
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spelling doaj-art-9c9a9468e04948ceaf2cf4a47d4a488e2025-08-20T03:36:19ZengMDPI AGBehavioral Sciences2076-328X2025-07-0115795410.3390/bs15070954Differential Effects of Hazardous Drinking on Post-Traumatic Stress Disorder Outcomes Across Two Prolonged Exposure Treatment FormatsCasey L. Straud0Kiara H. Buccellato1Edna B. Foa2Lily A. Brown3Carmen P. McLean4Tabatha H. Blount5Richard P. Schobitz6Bryann B. DeBeer7Joseph Mignogna8Brooke A. Fina9Brittany N. Hall-Clark10Christian C. Schrader11Jeffrey S. Yarvis12Vanessa M. Jacoby13Wyatt R. Evans14Brett T. Litz15Eric C. Meyer16Barbara L. Niles17Stacey Young-McCaughan18Terence M. Keane19Alan L. Peterson20Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USADepartment of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USACenter for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USACenter for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USADissemination and Training Division, National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA 94025, USADepartment of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USADepartment of Behavioral Health, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, TX 78234, USARocky Mountain MIRECC for Suicide Prevention, U.S. Department of Veterans Affairs, Aurora, CO 80045, USARocky Mountain MIRECC for Suicide Prevention, U.S. Department of Veterans Affairs, Aurora, CO 80045, USADepartment of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USADepartment of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USADepartment of Behavioral Health, Carl R. Darnall Army Medical Center, Fort Hood, TX 76544, USADepartment of Behavioral Health, Carl R. Darnall Army Medical Center, Fort Hood, TX 76544, USADepartment of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USADepartment of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USAMassachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA 02130, USADepartment of Counseling and Behavioral Health, University of Pittsburgh, Pittsburgh, PA 15260, USADepartment of Psychiatry, Boston University Chobanian and Avedisian School of Medicine, Boston, MA 02118, USADepartment of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USADepartment of Psychiatry, Boston University Chobanian and Avedisian School of Medicine, Boston, MA 02118, USADepartment of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USAIndividuals with post-traumatic stress disorder (PTSD) are at increased risk for hazardous drinking, which often complicates treatment and affects trauma-focused psychotherapy outcomes. The present study is an exploratory, secondary analysis investigating differential effects of prolonged exposure (PE) among those with and without hazardous drinking and whether treatment outcomes varied across these groups as a function of PE format. Data used were from a randomized controlled trial that examined two daily, compressed formats of PE treatment for PTSD (massed and intensive outpatient program) in military personnel and veterans (N = 234). Individuals without hazardous drinking had greater PTSD symptom reductions compared to those with hazardous drinking (<i>d</i> = 0.42, <i>p</i> = 0.001). However, the hazardous drinking group also demonstrated significant reductions in PTSD (<i>d</i> = 1.46, <i>p</i> < 0.001) following treatment, as well as in the number of drinks per week (<i>d</i> = 0.63, <i>p</i> = 0.025) at the 6-month follow-up. There was no significant difference in treatment engagement based on drinking classification and outcomes did not vary based on PE format. The findings suggest that PE is an appropriate treatment for individuals with PTSD and hazardous drinking. However, group differences in PTSD symptom reductions indicate concurrent hazardous drinking reduces treatment benefits of PE.https://www.mdpi.com/2076-328X/15/7/954post-traumatic stress disorderhazardous drinkingprolonged exposureintensive outpatient program treatment formatmassed treatment format
spellingShingle Casey L. Straud
Kiara H. Buccellato
Edna B. Foa
Lily A. Brown
Carmen P. McLean
Tabatha H. Blount
Richard P. Schobitz
Bryann B. DeBeer
Joseph Mignogna
Brooke A. Fina
Brittany N. Hall-Clark
Christian C. Schrader
Jeffrey S. Yarvis
Vanessa M. Jacoby
Wyatt R. Evans
Brett T. Litz
Eric C. Meyer
Barbara L. Niles
Stacey Young-McCaughan
Terence M. Keane
Alan L. Peterson
Differential Effects of Hazardous Drinking on Post-Traumatic Stress Disorder Outcomes Across Two Prolonged Exposure Treatment Formats
Behavioral Sciences
post-traumatic stress disorder
hazardous drinking
prolonged exposure
intensive outpatient program treatment format
massed treatment format
title Differential Effects of Hazardous Drinking on Post-Traumatic Stress Disorder Outcomes Across Two Prolonged Exposure Treatment Formats
title_full Differential Effects of Hazardous Drinking on Post-Traumatic Stress Disorder Outcomes Across Two Prolonged Exposure Treatment Formats
title_fullStr Differential Effects of Hazardous Drinking on Post-Traumatic Stress Disorder Outcomes Across Two Prolonged Exposure Treatment Formats
title_full_unstemmed Differential Effects of Hazardous Drinking on Post-Traumatic Stress Disorder Outcomes Across Two Prolonged Exposure Treatment Formats
title_short Differential Effects of Hazardous Drinking on Post-Traumatic Stress Disorder Outcomes Across Two Prolonged Exposure Treatment Formats
title_sort differential effects of hazardous drinking on post traumatic stress disorder outcomes across two prolonged exposure treatment formats
topic post-traumatic stress disorder
hazardous drinking
prolonged exposure
intensive outpatient program treatment format
massed treatment format
url https://www.mdpi.com/2076-328X/15/7/954
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