COCAINE DEPENDENCE WITH AND WITHOUT PTSD AMONG SUBJECTS IN THE NATIONAL-INSTITUTE-ON-DRUG-ABUSE COLLABORATIVE COCAINE TREATMENT STUDY

Objective: This study examined the prevalence of lifetime traumatic ev ents and current symptoms of posttraumatic stress disorder (PTSD) amon g treatment-seeking cocaine-dependent outpatients and compared patient s with and without PTSD on current substance use, psychopathology, and sociodemographic characteristics. Method: The subjects were 122 adult cocaine-dependent outpatients participating in a treatment outcome st udy of psychosocial therapy. In addition to standard self-report and i nterview measures of psychopathology and substance use, the subjects c ompleted the Trauma History Questionnaire and the PTSD checklist befor e entering treatment. Results: These patients experienced a large numb er of lifetime traumatic events (mean = 5.7); men experienced more gen eral disasters and crime-related traumas than women, and women experie nced more physical and sexual abuse than men. According to self-report measures, 20.5% of the subjects currently met the DSM-III-R criteria for PTSD; the rate of PTSD was 30.2% among women and 15.2% among men. Patients with PTSD had significantly higher rates of co-occurring axis I and axis II disorders, interpersonal problems, medical problems, re sistance to treatment, and psychopathology symptoms than patients with out PTSD. Psychopathology symptoms represented the most consistent di fference between the two groups and provided the best prediction of PT SD status in a logistic regression. However, the groups did not differ significantly in current substance use ol sociodemographic characteri stics. Conclusions: These findings underscore the value of screening s ubstance abusers for PTSD, because it can identify a small but substan tial number who might require additional treatment. Further studies of the relationship between PTSD and substance abuse appear warranted.