Pre-treatment predictors of dropout from prolonged exposure therapy in patients with chronic posttraumatic stress disorder and comorbid substance use disorders
Open accessAbstract
Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) are commonly co-occurring disorders associated with more adverse consequences than PTSD alone. Prolonged exposure therapy (PE) is one of the most efficacious treatments for PTSD. However, among individuals with PTSD-SUD, 35-62% of individuals drop out of trauma-focused exposure treatments. Thus, it is important to identify predictors of PTSD treatment dropout among substance abusers with PTSD in order to gain information about adapting treatment strategies to enhance retention and outcomes. The current study explored pre-treatment predictors of early termination from PE treatment in a sample of 85 individuals receiving concurrent treatment for PTSD and a SUD in a residential treatment facility as part of a randomized controlled trial. The results indicated that less education and more anxiety sensitivity uniquely predicted PE treatment dropout. Demographic variables, PTSD severity, SUD severity, mental health comorbidities, and emotion regulation difficulties did not predict treatment dropout. These results suggest that adding pre-treatment interventions that address anxiety sensitivity, and promote social adjustment and cognitive flexibility, could possibly improve PE retention rates in clients with high anxiety or low education.
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The observed retention rate is consistent with previous trials of first-line PTSD treatments and in routine clinical care settings, and higher than in a PTSD exposure-based treatment trial with a PTSD/SUD population.
“However, this is consistent with previous trials of first-line PTSD treatments [19] and in routine clinical care settings [46] and, importantly, higher than what is seen in a PTSD exposure-based treatment trial with a PTSD/SUD population [47].”
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References 57 · Cited by 71
Research works printed but not linked: 2
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- Sobbel LC Sobbel MB 1992 Timeline follow-back: A technique for assessing self-reported ethanol consumption Allen J Litten RZ Measuring alcohol consumption: Psychosocial and biological methods 41 72 Totowa, NJ Humana Press
- Authors
- Belleau, E. L., Chin, E. G., Wanklyn, S. G., Zambrano-Vazquez, L., Schumacher, J. A., & Coffey, S. F.
- Affiliations
- University of Mississippi Medical Center (US)
- Corresponding author
- Coffey, Scott F.
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2017-04
- Volume
- 91
- Pages
- 43-50
- ISSN
- 0005-7967 (ISSN-L)
- PMC
- PMC5328858
- OpenAlex
- W2581848244
- Cited by
- 71
- References
- 57
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 12 · 2023: 9 · 2022: 10 · 2021: 9 · 2020: 9 · 2019: 4 · 2018: 3 · 2017: 1
- FWCI
- 5.77
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R01AA016816)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- prolonged exposure therapy, post-traumatic stress disorder, substance use disorders, treatment discontinuation, anxiety sensitivity, educational attainment, treatment retention, residential treatment
- MeSH terms
- Adult, Alcoholism, Female, Humans, Implosive Therapy, Male, Patient Dropouts, Risk Factors, Stress Disorders, Post-Traumatic, United States, Treatment Outcome, Young Adult
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