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Pathways to change: Use trajectories following trauma-informed treatment of women with co-occurring post-traumatic stress disorder and substance use disorders

Corresponding Author

Teresa López-Castro

Department of Psychology, The City College of New York—CUNY, New York City, USA

Correspondence to Dr Teresa López-Castro, Department of Psychology, The City College of New York—CUNY, 160 Convent Avenue, NAC Building, Rm 7/120, New York City, NY 10031, USA. Tel: +212 650 8965; Fax: +212 650 8910; E-mail: [email protected]Search for more papers by this author

Mei-Chen Hu,

Mei-Chen Hu

Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York City, USA

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Santiago Papini,

Santiago Papini

Department of Psychology, The City College of New York—CUNY, New York City, USA

New York State Psychiatric Institute, Columbia University Medical Center, New York City, USA

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Lesia M. Ruglass,

Lesia M. Ruglass

Department of Psychology, The City College of New York—CUNY, New York City, USA

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Denise A. Hien,

Denise A. Hien

Department of Psychology, The City College of New York—CUNY, New York City, USA

New York State Psychiatric Institute, Columbia University Medical Center, New York City, USA

Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York City, USA

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Teresa López-Castro,

Corresponding Author

Teresa López-Castro

Department of Psychology, The City College of New York—CUNY, New York City, USA

Mei-Chen Hu,

Mei-Chen Hu

Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York City, USA

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Santiago Papini,

Santiago Papini

Department of Psychology, The City College of New York—CUNY, New York City, USA

New York State Psychiatric Institute, Columbia University Medical Center, New York City, USA

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Lesia M. Ruglass,

Lesia M. Ruglass

Department of Psychology, The City College of New York—CUNY, New York City, USA

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Denise A. Hien,

Denise A. Hien

Department of Psychology, The City College of New York—CUNY, New York City, USA

New York State Psychiatric Institute, Columbia University Medical Center, New York City, USA

Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York City, USA

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First published: 04 March 2015

https://doi.org/10.1111/dar.12230

Citations: 38

Teresa López-Castro PhD, Assistant Professor, Mei-Chen Hu PhD, Research Scientist, Santiago Papini MA, Research Fellow, Lesia M. Ruglass PhD, Assistant Professor, Denise A. Hien PhD, Professor.

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Abstract

Introduction and Aims

Despite advances towards integration of care for women with co-occurring substance use disorder (SUD) and post-traumatic stress disorder (PTSD), low abstinence rates following SUD/PTSD treatment remain the norm. The utility of investigating distinct substance use trajectories is a critical innovation in the detection and refining of effective interventions for this clinical population.

Design and Methods

The present study reanalysed data from the largest randomised clinical trial to date for co-occurring SUD and PTSD in women (National Drug Abuse Treatment Clinical Trials Network; Women and Trauma Study). Randomised participants (n = 353) received one of two interventions in addition to treatment as usual for SUD: (i) trauma-informed integrative treatment for PTSD/SUD; or (ii) an active control psychoeducation course on women's health. The present study utilised latent growth mixture models (LGMM) with multiple groups to estimate women's substance use patterns during the 12-month follow-up period.

Results

Findings provided support for three different trajectories of substance use in the post-treatment year: (i) consistently low likelihood and use frequency; (ii) consistently high likelihood and use frequency; and (iii) high likelihood and moderate use frequency. Covariate analyses revealed improvement in PTSD severity was associated with membership in a specific substance use trajectory, although receiving trauma-informed treatment was not. Additionally, SUD severity, age and after-care efforts were shown to be related to trajectory membership.

Discussion and Conclusions

Findings highlight the necessity of accounting for heterogeneity in post-treatment substance use, relevance of trauma-informed care in SUD recovery and benefits of incorporating methodologies like LGMM when evaluating SUD treatment outcomes. [López-Castro T, Hu M-C, Papini S, Ruglass LM, Hien DA. Pathways to change: Use trajectories following trauma-informed treatment of women with co-occurring post-traumatic stress disorder and substance use disorders. Drug Alcohol Rev 2015]

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Citing Literature

Volume34, Issue3

Special Issue:Trauma‐informed care in alcohol and other drug services, Guest Editor: Katherine Mills

May 2015

Pages 242-251

Pathways to change: Use trajectories following trauma-informed treatment of women with co-occurring post-traumatic stress disorder and substance use disorders

Abstract

Introduction and Aims

Design and Methods

Results

Discussion and Conclusions

References

Citing Literature

References

Information

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Pathways to change: Use trajectories following trauma-informed treatment of women with co-occurring post-traumatic stress disorder and substance use disorders

Abstract

Introduction and Aims

Design and Methods

Results

Discussion and Conclusions

References

Citing Literature

References

Related

Information