ArticleBehavioural and cognitive psychotherapy2020
Does trauma-focused exposure therapy exacerbate symptoms among patients with comorbid PTSD and substance use disorders?
Article in Behavioural and cognitive psychotherapy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01338506 (Integrated Treatment of Operation Enduring Freedom/Operation Iraqi Freedom Veterans With Post-traumatic Stress Disorder and Substance Use Disorders), which is not on this map. Cited by 15 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Integrated Treatment of Operation Enduring Freedom/Operation Iraqi Freedom Veterans With Post-traumatic Stress Disorder and Substance Use Disorders
Who cites it
15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Cognitive Behavioural Therapy and Dual Diagnosis: A Systematic Review Exploring Its Effectiveness and Implications for Nursing Practice.International journal of mental health nursing · 2025Pooled it
- Project harmony: A systematic review and network meta-analysis of psychotherapy and pharmacologic trials for comorbid posttraumatic stress, alcohol, and other drug use disorders.Psychological bulletin · 2024Pooled it
- A meta-analysis of dropout from evidence-based psychological treatment for post-traumatic stress disorder (PTSD) in children and young people.European journal of psychotraumatology · 2021Pooled it
- Trauma-Integrated Mindfulness-Based Relapse Prevention for Women with Comorbid Post-Traumatic Stress Disorder and Substance Use Disorder: A Cluster Randomized Controlled Feasibility and Acceptability Trial.Journal of integrative and complementary medicine · 2022Trial
- Does exposure exacerbate symptoms in veterans with PTSD and alcohol use disorder?Psychological trauma : theory, research, practice and policy · 2021Trial
- PTSD Symptoms change in response to a brief intensive trauma-focused treatment programme in non-veterans and veterans with war-related PTSD.European journal of psychotraumatology · 2025Article
- Influence of Posttraumatic Stress Disorder Severity on Return to Substance Use Immediately Following Residential Substance Use Treatment.International journal of mental health and addiction · 2025Article
- Predictors of evidence-based psychotherapy initiation among veterans with co-occurring PTSD and substance use disorder.Frontiers in psychiatry · 2024Article
- Treating posttraumatic stress disorder and alcohol use disorder comorbidity: Current pharmacological therapies and the future of MDMA-integrated psychotherapy.Journal of psychopharmacology (Oxford, England) · 2023Review
- Exploring the Prevalence of PTSD in Hand Trauma: A Comprehensive Study.Brain sciences · 2023Article
- Study protocol: implementing and evaluating a trauma-informed model of care in residential youth treatment for substance use disorders.Frontiers in psychiatry · 2023Article
- Effects of intensive trauma-focused treatment of individuals with both post-traumatic stress disorder and borderline personality disorder.European journal of psychotraumatology · 2022Article
- Article
- Trauma-focused treatment outcome for complex PTSD patients: results of an intensive treatment programme.European journal of psychotraumatology · 2020Article
- A Narrative Literature Review of the Epidemiology, Etiology, and Treatment of Co-Occurring Panic Disorder and Opioid Use Disorder.Journal of dual diagnosisReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundAlthough 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).
aimThis 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.
methodParticipants (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.
resultsAt 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.
conclusionsThis 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.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.