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Acceptance and Commitment Therapy for Co-Occurring Posttraumatic Stress Disorder and Alcohol Use Disorders in Veterans: Pilot Treatment Outcomes.

Publication ,  Journal Article
Meyer, EC; Walser, R; Hermann, B; La Bash, H; DeBeer, BB; Morissette, SB; Kimbrel, NA; Kwok, O-M; Batten, SV; Schnurr, PP
Published in: J Trauma Stress
October 2018

Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) frequently co-occur and are associated with worse outcomes together than either disorder alone. A lack of consensus regarding recommendations for treating PTSD-AUD exists, and treatment dropout is a persistent problem. Acceptance and Commitment Therapy (ACT), a transdiagnostic, mindfulness- and acceptance-based form of behavior therapy, has potential as a treatment option for PTSD-AUD. In this uncontrolled pilot study, we examined ACT for PTSD-AUD in 43 veterans; 29 (67%) completed the outpatient individual therapy protocol (i.e., ≥ 10 of 12 sessions). Clinician-assessed and self-reported PTSD symptoms were reduced at posttreatment, ds = 0.79 and 0.96, respectively. Self-reported symptoms of PTSD remained lower at 3-month follow-up, d = 0.88. There were reductions on all alcohol-related outcomes (clinician-assessed and self-reported symptoms, total drinks, and heavy drinking days) at posttreatment and 3-month follow-up, dmean = 0.91 (d range: 0.65-1.30). Quality of life increased at posttreatment and follow-up, ds = 0.55-0.56. Functional disability improved marginally at posttreatment, d = 0.35; this effect became significant by follow-up, d = 0.52. Fewer depressive symptoms were reported at posttreatment, d = 0.50, and follow-up, d = 0.44. Individuals experiencing suicidal ideation reported significant reductions by follow-up. Consistent with the ACT theoretical model, these improvements were associated with more between-session mindfulness practice and reductions in experiential avoidance and psychological inflexibility. Recommendations for adapting ACT to address PTSD-AUD include assigning frequent between-session mindfulness practice and initiating values clarification work and values-based behavior assignments early in treatment.

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Published In

J Trauma Stress

DOI

EISSN

1573-6598

Publication Date

October 2018

Volume

31

Issue

5

Start / End Page

781 / 789

Location

United States

Related Subject Headings

  • Veterans
  • Treatment Outcome
  • Stress Disorders, Post-Traumatic
  • Severity of Illness Index
  • Quality of Life
  • Psychiatry
  • Pilot Projects
  • Mindfulness
  • Male
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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Meyer, E. C., Walser, R., Hermann, B., La Bash, H., DeBeer, B. B., Morissette, S. B., … Schnurr, P. P. (2018). Acceptance and Commitment Therapy for Co-Occurring Posttraumatic Stress Disorder and Alcohol Use Disorders in Veterans: Pilot Treatment Outcomes. J Trauma Stress, 31(5), 781–789. https://doi.org/10.1002/jts.22322
Meyer, Eric C., Robyn Walser, Barbara Hermann, Heidi La Bash, Bryann B. DeBeer, Sandra B. Morissette, Nathan A. Kimbrel, Oi-Man Kwok, Sonja V. Batten, and Paula P. Schnurr. “Acceptance and Commitment Therapy for Co-Occurring Posttraumatic Stress Disorder and Alcohol Use Disorders in Veterans: Pilot Treatment Outcomes.J Trauma Stress 31, no. 5 (October 2018): 781–89. https://doi.org/10.1002/jts.22322.
Meyer EC, Walser R, Hermann B, La Bash H, DeBeer BB, Morissette SB, et al. Acceptance and Commitment Therapy for Co-Occurring Posttraumatic Stress Disorder and Alcohol Use Disorders in Veterans: Pilot Treatment Outcomes. J Trauma Stress. 2018 Oct;31(5):781–9.
Meyer, Eric C., et al. “Acceptance and Commitment Therapy for Co-Occurring Posttraumatic Stress Disorder and Alcohol Use Disorders in Veterans: Pilot Treatment Outcomes.J Trauma Stress, vol. 31, no. 5, Oct. 2018, pp. 781–89. Pubmed, doi:10.1002/jts.22322.
Meyer EC, Walser R, Hermann B, La Bash H, DeBeer BB, Morissette SB, Kimbrel NA, Kwok O-M, Batten SV, Schnurr PP. Acceptance and Commitment Therapy for Co-Occurring Posttraumatic Stress Disorder and Alcohol Use Disorders in Veterans: Pilot Treatment Outcomes. J Trauma Stress. 2018 Oct;31(5):781–789.
Journal cover image

Published In

J Trauma Stress

DOI

EISSN

1573-6598

Publication Date

October 2018

Volume

31

Issue

5

Start / End Page

781 / 789

Location

United States

Related Subject Headings

  • Veterans
  • Treatment Outcome
  • Stress Disorders, Post-Traumatic
  • Severity of Illness Index
  • Quality of Life
  • Psychiatry
  • Pilot Projects
  • Mindfulness
  • Male
  • Humans