Treatment for co-occurring posttraumatic stress disorder and substance use disorders among veterans and civilians: A test of causally moderated comparative effectiveness.

作者：Shannon M. Blakey, Antonio A. Morgan‐López, Alexander C. Kline, Alina Shevorykin, Sonya B. Norman, Therese K. Killeen, Sudie E. Back, Tracy L. Simpson, Lissette M. Saavedra, Ismene L. Petrakis, Denise A. Hien · 发表于：Psychological Trauma Theory Research Practice and Policy · 年份：2025 · DOI：10.1037/tra0002043 · 被引用次数：3 · 研究领域：Posttraumatic Stress Disorder Research、Trauma and Emergency Care Studies、Traumatic Brain Injury Research

OBJECTIVE: The prevalence and negative sequelae of co-occurring posttraumatic stress disorder and substance use disorder (PTSD + SUD) are well documented. Findings from evidence syntheses regarding which PTSD + SUD treatments work best overall have been mixed, potentially because these treatments are not equally effective for all PTSD + SUD patient subgroups. Epidemiological and qualitative research suggest that veteran status may be related to differential PTSD + SUD treatment response. This study, applying recent quantitative methodological advances in evidence synthesis, is the first to examine the potential moderating effect of veteran status on PTSD + SUD treatment outcome. METHOD: = 3,228) from Project Harmony, a meta-analysis of individual PTSD + SUD patient data from sociodemographically diverse samples incorporating propensity score weighting and integrative data analysis. Outcome models (examined separately for harmonized indicators of latent PTSD, alcohol use, and drug use severity) were fit under propensity score weighting multilevel modeling. RESULTS: Tests of causally moderated comparative effectiveness showed that trauma-focused psychotherapy targeting PTSD and integrated trauma-focused psychotherapy targeting PTSD and SUD were both superior to treatment as usual for alcohol use severity outcomes, and this effect was stronger for veterans than civilians. Analyses did not provide evidence for differential response to active PTSD + SUD psychotherapies, relative t...