A novel prolonged exposure therapy protocol for improving therapy session attendance and PTSD symptoms among adults receiving buprenorphine or methadone treatment

IF 3.9 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2025-01-01 DOI:10.1016/j.drugalcdep.2024.112507

Kelly R. Peck , Jillian Giannini , Gary J. Badger , Rebecca Cole , Stacey C. Sigmon

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引用次数: 0

Abstract

Background

Among individuals with opioid use disorder (OUD), the prevalence of posttraumatic stress disorder (PTSD) is higher than in the general population. Prolonged exposure (PE) therapy is highly efficacious for improving PTSD symptoms. However, few studies have evaluated PE in individuals receiving medications for OUD (MOUD) and treatment completion rates have been low. This randomized trial evaluated the efficacy of a novel protocol for improving PE attendance and PTSD symptoms among adults receiving buprenorphine or methadone treatment.

Methods

Eligible participants (n=52) were randomized to one of three 12-week experimental conditions: (a) continued MOUD treatment as usual (TAU; n=17), (b) Prolonged Exposure Therapy (PE; n=17), or (c) PE with financial incentives contingent upon PE session attendance (PE+; n=18). Primary outcomes included percent of PE sessions attended and Clinician Administered PTSD Scale for DSM-5 (CAPS-5).

Results

PE+ participants attended significantly more therapy sessions than PE participants (88 % vs 33 %; p<.001). All three groups reported significant (p<.05) improvements in CAPS-5 scores between intake and week 12, with no significant group differences. However, PE+ participants achieved significantly greater improvements in self-reported PTSD symptoms (p=.02) than TAU participants, as well as higher rates of diagnostic remission compared to TAU and PE participants (p<.001). Participants in the two PE groups did not exhibit an increase in non-prescribed drug use.

Conclusions

In this study of adults receiving MOUD treatment, PE+ was efficacious for increasing PE attendance. Our findings also provide promising support for the efficacy of PE+ for improving PTSD symptoms without exacerbating substance use.

Clinical trial number

NCT04104022

查看原文本刊更多论文

一种新的延长暴露治疗方案，可改善接受丁丙诺啡或美沙酮治疗的成人的治疗出勤率和PTSD症状。

背景：在阿片类药物使用障碍（OUD）患者中，创伤后应激障碍（PTSD）的患病率高于普通人群。延长暴露（PE）治疗对改善PTSD症状非常有效。然而，很少有研究评估接受OUD （mod）药物治疗的个体PE，治疗完成率很低。这项随机试验评估了一种新方案在接受丁丙诺啡或美沙酮治疗的成年人中改善体育课出勤率和PTSD症状的效果。方法：符合条件的参与者（n=52）被随机分配到三种为期12周的实验条件之一：(a)照常继续mod治疗(TAU；n=17), (b)延长暴露治疗（PE）；n=17)，或(c)体育与财政奖励取决于体育课程出席率(PE+；n = 18)。主要结果包括参加体育课程的百分比和临床医生管理的DSM-5 PTSD量表（CAPS-5）。结果：体育+参与者比体育参与者参加了更多的治疗疗程(88% vs 33%；结论：在这项接受mod治疗的成人研究中，PE+对提高体育出勤率是有效的。我们的研究结果也为PE+在不加剧药物使用的情况下改善PTSD症状的功效提供了有希望的支持。临床试验号：NCT04104022。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Drug and alcohol dependence 医学-精神病学

CiteScore

7.40

自引率

7.10%

发文量

409

审稿时长

41 days

期刊介绍： Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.