Does substance abuse affect outcomes for trauma-focused treatment of combat-related PTSD?

Comorbidity of substance use disorders (SUDs) and posttraumatic stress disorder (PTSD) among combat Veterans is common, which creates a need for special consideration of treatment options. Controversy regarding trauma-focused treatments for individuals with comorbid SUDs may cause barriers to treatment delivery. Cognitive processing therapy (CPT) is frequently recommended for treatment of PTSD, but little is known about whether substance use comorbidity affects the outcome. This study compared outcomes for Veterans with PTSD and a substance misuse pattern against Veterans with PTSD without a comorbid SUD, who participated in a six-week residential group CPT treatment program. Lack of significant differences between groups on outcomes for PTSD or depression, p > 0.05, suggests that individuals with comorbid substance misuse have outcomes for PTSD and depression similar to those without substance use comorbidity. Trauma-focused treatments may not be as problematic in this population as many clinicians believe. Attrition and demographic differences between the groups were also explored.