scholarly journals The influence of traumatic brain injury on treatment outcomes of Concurrent Treatment for PTSD and Substance Use Disorders Using Prolonged Exposure (COPE) in veterans

2017 ◽  
Vol 78 ◽  
pp. 48-53 ◽  
Author(s):  
Daniel F. Gros ◽  
Cynthia L. Lancaster ◽  
Michael David Horner ◽  
Derek D. Szafranski ◽  
Sudie E. Back
Keyword(s):  
Traumatic Brain Injury ◽  
Substance Use ◽  
Brain Injury ◽  
Treatment Outcomes ◽  
Substance Use Disorders ◽  
Prolonged Exposure ◽  
Concurrent Treatment

A prospective examination of Axis I psychiatric disorders in the first 5 years following moderate to severe traumatic brain injury

2016 ◽  
Vol 46 (6) ◽  
pp. 1331-1341 ◽  
Author(s):  
Y. Alway ◽  
K. R. Gould ◽  
L. Johnston ◽  
D. McKenzie ◽  
J. Ponsford
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Substance Use ◽  
Brain Injury ◽  
Anxiety Disorders ◽  
Psychiatric Disorders ◽  
Substance Use Disorders ◽  
First Year ◽  
Post Injury ◽  
Over Time

BackgroundPsychiatric disorders commonly emerge during the first year following traumatic brain injury (TBI). However, it is not clear whether these disorders soon remit or persist for long periods post-injury. This study aimed to examine, prospectively: (1) the frequency, (2) patterns of co-morbidity, (3) trajectory, and (4) risk factors for psychiatric disorders during the first 5 years following TBI.MethodParticipants were 161 individuals (78.3% male) with moderate (31.2%) or severe (68.8%) TBI. Psychiatric disorders were diagnosed using the Structured Clinical Interview for DSM-IV, administered soon after injury and 3, 6 and 12 months, and 2, 3, 4 and 5 years post-injury. Disorder frequencies and generalized estimating equations were used to identify temporal relationships and risk factors.ResultsIn the first 5 years post-injury, 75.2% received a psychiatric diagnosis, commonly emerging within the first year (77.7%). Anxiety, mood and substance-use disorders were the most common diagnostic classes, often presenting co-morbidly. Many (56.5%) experienced a novel diagnostic class not present prior to injury. Disorder frequency ranged between 61.8 and 35.6% over time, decreasing by 27% [odds ratio (OR) 0.73, 95% confidence interval (CI) 0.65–0.83] with each year post-injury. Anxiety disorders declined significantly over time (OR 0.73, 95% CI 0.63–0.84), whilst mood and substance-use disorder rates remained stable. The strongest predictors of post-injury disorder were pre-injury disorder (OR 2.44, 95% CI 1.41–4.25) and accident-related limb injury (OR 1.78, 95% CI 1.03–3.07).ConclusionsFindings suggest the first year post-injury is a critical period for the emergence of psychiatric disorders. Disorder frequency declines thereafter, with anxiety disorders showing greater resolution than mood and substance-use disorders.

scholarly journals Combat Posttraumatic Stress Disorder, Substance Use Disorders, and Traumatic Brain Injury

2009 ◽  
Vol 3 (4) ◽  
pp. 179-188 ◽  
Author(s):  
Kathleen T. Brady ◽  
Peter Tuerk ◽  
Sudie E. Back ◽  
Michael E. Saladin ◽  
Angela E. Waldrop ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Posttraumatic Stress Disorder ◽  
Substance Use ◽  
Brain Injury ◽  
Posttraumatic Stress ◽  
Substance Use Disorders ◽  
Stress Disorder

scholarly journals Does trauma-focused exposure therapy exacerbate symptoms among patients with comorbid PTSD and substance use disorders?

2019 ◽  
Vol 48 (1) ◽  
pp. 38-53
Author(s):  
Cynthia L. Lancaster ◽  
Daniel F. Gros ◽  
Michael C. Mullarkey ◽  
Christal L. Badour ◽  
Therese K. Killeen ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Prolonged Exposure ◽  
Exposure Therapy ◽  
Psychological Symptoms ◽  
Depression Symptoms ◽  
Post Traumatic Stress ◽  
Concurrent Treatment ◽  
Symptom Exacerbation ◽  
Post Traumatic

AbstractBackground: Although exposure-based therapy is a well-established, effective treatment for post-traumatic stress disorder (PTSD), some practitioners report reluctance to implement it due to concerns that it may exacerbate symptoms of PTSD and commonly comorbid disorders, such as substance use disorders (SUD).Aim: This study compared the exacerbation of psychological symptoms among participants with comorbid PTSD and SUD who received either SUD treatment alone or SUD treatment integrated with exposure therapy for PTSD.Method: Participants (N = 71) were treatment-seeking, military Veterans with comorbid PTSD and SUD who were randomized to 12 individual sessions of either (1) an integrated, exposure-based treatment (Concurrent Treatment of PTSD and Substance Use Disorders using Prolonged Exposure; COPE); or (2) a non-exposure-based, SUD-only treatment (Relapse Prevention; RP). We examined between-group differences in the frequency of statistically reliable exacerbations of PTSD, SUD and depression symptoms experienced during treatment.Results: At each of the 12 sessions, symptom exacerbation was minimal and generally equally likely in either treatment group. However, an analysis of treatment completers suggests that RP participants experienced slightly more exacerbations of PTSD symptoms during the course of treatment.Conclusions: This study is the first to investigate symptom exacerbation throughout trauma-focused exposure therapy for individuals with comorbid PTSD and SUD. Results add to a growing literature which suggests that trauma-focused, exposure-based therapy does not increase the risk of symptom exacerbation relative to non-exposure-based therapy.

Lifetime history of traumatic brain injury among persons with substance use disorders

Brain Injury ◽  
2012 ◽  
Vol 26 (2) ◽  
pp. 139-150 ◽  
Author(s):  
John D. Corrigan ◽  
Jennifer Bogner ◽  
Christopher Holloman
Keyword(s):  
Traumatic Brain Injury ◽  
Substance Use ◽  
Brain Injury ◽  
Substance Use Disorders ◽  
Lifetime History ◽  
History Of

scholarly journals Concurrent treatment of substance use disorders and PTSD using prolonged exposure: A randomized clinical trial in military veterans

2019 ◽  
Vol 90 ◽  
pp. 369-377 ◽  
Author(s):  
Sudie E. Back ◽  
Therese Killeen ◽  
Christal L. Badour ◽  
Julianne C. Flanagan ◽  
Nicholas P. Allan ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Substance Use ◽  
Randomized Clinical Trial ◽  
Substance Use Disorders ◽  
Prolonged Exposure ◽  
Military Veterans ◽  
Concurrent Treatment
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