Motives for substance use and 6-month substance use outcomes among detoxification patients with a history of physical or sexual abuse or posttraumatic stress disorder.

Trauma-exposed individuals with a history of physical or sexual abuse or documented posttraumatic stress disorder (PTSD) diagnosis may use substances to address trauma-related symptoms. However, the motives for using substances among adults with a trauma history or PTSD are unclear despite their informative role in treatment planning. Additionally, trauma is associated with poorer substance use outcomes, although this has not been examined among detoxification patients. The current study examined motives for substance use at baseline and substance use outcomes during 6 months postbaseline among 298 veteran detoxification patients (i.e., alcohol, opioids, or both) with and without (a) a history of physical or sexual abuse and (b) a PTSD diagnosis. At baseline, participants with a physical or sexual abuse history were more likely to report the use of substances to temporarily lower stress, forget problems, and avoid uncomfortable feelings than those without this history, ds = 0.25-0.40. Compared with participants without a PTSD diagnosis, participants with diagnosed PTSD were more likely to report using substances to temporarily lower stress, d = 0.25. Longitudinal analyses demonstrated that the baseline characteristics of physical abuse history, sexual abuse history, and diagnosed PTSD were all associated with higher scores on a measure of risk factors for relapse (e.g., cravings, family/social problems) as assessed during the postdetoxification period, φ = .13, .10, and .09, respectively. Detoxification patients with physical and/or sexual abuse histories or PTSD diagnoses may need treatments that better address trauma symptoms to help them sustain abstinence.

A home-based telehealth randomized controlled trial of skills training in affective and interpersonal regulation versus present-centered therapy for women veterans who have experienced military sexual trauma.

OBJECTIVE: This randomized trial tested the effectiveness of Skills Training in Affective and Interpersonal Regulation (STAIR) compared to present-centered therapy (PCT) delivered virtually to women veterans who had experienced military sexual trauma (MST) and screened positive for posttraumatic stress disorder (PTSD). METHOD: One hundred sixty-one eligible women veterans were randomized into the study. The primary outcome was clinician-assessed PTSD severity (Clinician-Administered PTSD Scale-5), while secondary outcomes included social support and several other symptom measures at posttreatment through 2- and 4-month follow-up. RESULTS: PTSD severity decreased in both conditions by posttreatment but significantly more (p = .028, d = 0.39) in STAIR (d = 1.12 [0.87, 1.37]) than PCT (d = .78 [0.54, 1.02]). STAIR was also superior in improving social support and emotion regulation and reducing depression and negative cognitions. Improvement in psychosocial functioning was moderate and did not differ between conditions. All changes were maintained through 2- and 4-month follow-ups. Dropout rates were low and did not differ (19.0% and 12.2%, respectively). CONCLUSION: STAIR provided superior outcomes compared to PCT regarding PTSD, social support, and multiple types of mental health problems among women veterans with MST. The application of STAIR to other populations with social support and related concerns warrants investigation. The substantial effect sizes for PTSD symptoms in both treatments suggest that they are practical alternatives for individuals who do not wish to participate in trauma-focused therapy and may increase engagement in mental health services. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Mental disorder prevalence among populations impacted by coronavirus pandemics: A multilevel meta-analytic study of COVID-19, MERS & SARS.

OBJECTIVE: Through a systematic review and meta-analysis of research on COVID-19, severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS) pandemics, we investigated whether mental disorder prevalence: (a) was elevated among populations impacted by coronavirus pandemics (relative to unselected populations reported in the literature), and (b) varied by disorder (undifferentiated psychiatric morbidity, anxiety, depressive, posttraumatic stress disorders [PTSD]) and impacted population (community, infected/recovered, healthcare provider, quarantined). METHOD: From 68 publications (N = 87,586 participants), 808 estimates were included in a series of multilevel meta-analyses/regressions including random effects to account for estimates nested within studies. RESULTS: Median summary point prevalence estimates varied by disorder and population. Psychiatric morbidity (20-56%), PTSD (10-26%) and depression (9-27%) were most prevalent in most populations. The highest prevalence of each disorder was found among infected/recovered adults (18-56%), followed by healthcare providers (11-28%) and community adults (11-20%). Prevalence estimates were often notably higher than reported for unselected samples. Sensitivity analyses demonstrated that overall prevalence estimates moderately varied by pandemic, study location, and mental disorder measure type. CONCLUSION: Coronavirus pandemics are associated with multiple mental disorders in several impacted populations. Needed are investigations of causal links between specific pandemic-related stressors, threats, and traumas and mental disorders.