POSTTRAUMATIC-STRESS-DISORDER IN SUBSTANCE-ABUSE PATIENTS - RELATIONSHIP TO 1-YEAR POSTTREATMENT OUTCOMES

Patients with posttraumatic stress disorder (PTSD) and substance abuse (SA-PTSD) diagnoses were compared with patients with only substance u se diagnoses (SA only) and those with substance abuse and Axis I psych iatric diagnoses other than PTSD (SA-PSY) on outcomes 1 year after sub stance abuse treatment. At follow-up, patients with PTSD reported more problems that directly resulted from substance use, had more psycholo gical distress, and reported less support from friends than both SA-on ly and SA-PSY patients. SA-PTSD patients were less likely to be employ ed and more likely to be readmitted for inpatient/residential treatmen t during the follow-up than SA-only patients. The effect of PTSD on 1- year problems from substance use was partially mediated by greater use of emotional discharge coping, having more positive expectancies rega rding substance use, and expecting fewer benefits from quitting. Expec ting fewer benefits from quitting partially explained the relationship between PTSD and 1-year friend support.