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2012 HSR&D/QUERI National Conference Abstract

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2012 National Meeting

3018 — Skills Training in Affective and Interpersonal Regulation (STAIR) Group Treatment for Veterans with Comorbid PTSD and SUD

Kulkarni M, and Cloitre M, NC-PTSD Division of Dissemination and Training, VAPAHCS;

Veterans suffering from co-occurring PTSD-SUD experience greater impairment and poorer treatment outcomes than those with only PTSD or SUD. It has been proposed that emotion regulation difficulties may contribute to the maintenance of both PTSD and SUD. Additionally, poor interpersonal skills increase risk for individuals suffering from PTSD-SUD by impairing relationship functioning and decreasing ability to successfully access social support during times of distress. To date, these two important domains have not been specifically targeted for comorbid PTSD-SUD patients. A recently developed cognitive-behavioral intervention, Skills Training in Affective and Interpersonal Regulation (STAIR), has been tested with first-responders after the September 11th attacks and was found to be effective in improving all of the above difficulties including reduction of use of alcohol and drugs and increased use of social support to cope.

The purpose of the study was to evaluate the feasibility, safety and possible efficacy of incorporating STAIR groups into an ongoing residential PTSD-SUD treatment program. Three cycles of 10-session STAIR groups were completed. Pre-and post-treatment data were collected among participating Veterans (n = 18). Outcomes on the PCL, the Difficulties in Emotion Regulation Scale, the BSI subscales of hostility and interpersonal sensitivity, and the Penn Alcohol Craving Scale were obtained. In addition, qualitative data on the feasibility of and satisfaction with the treatment was obtained from both staff and patients.

Analyses of pre-to-post changes indicated statistically and clinically significant reductions in all symptom categories. Staff assessed the incorporation of the group treatment as complementary to the PTSD-SUD program and activities, and Veterans reported high satisfaction with the group.

The pilot study indicated that a focused skills group in the context of a residential PTSD-SUD treatment program provided significant reductions in both PTSD and SUD symptoms.

The positive outcomes emerging from the pilot study suggest the value of conducting further studies. Such research will test the potential benefits of a brief, skills focused treatment group that can be incorporated into PTSD-SUD programs which will efficiently target problems that contribute to problems underlying both PTSD and SUD symptoms.

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