Increased Resilience is Associated with Positive Treatment Outcomes for Veterans with Comorbid PTSD and Substance Use Disorders

ABSTRACT

Objective: Resilience has been associated with less severe psychiatric symptomatology and better treatment outcomes among individuals with posttraumatic stress disorder (PTSD) and substance use disorders. However, it remains unknown whether resilience increases during psychotherapy within the comorbid PTSD and substance use disorder population with unique features of dual diagnosis, including trauma cue-related cravings. We tested whether veterans seeking psychotherapy for comorbid PTSD and substance use disorder reported increased resilience from pre- to posttreatment. We also tested whether increased resilience was associated with greater decreases in posttreatment PTSD and substance use disorder symptoms. Methods: Participants were 29 male veterans (M_age = 49.07 years, SD = 11.24 years) receiving six-week residential day treatment including cognitive processing therapy for PTSD and cognitive behavioral therapy for substance use disorder. Resilience, PTSD symptoms, and trauma cue-related cravings were assessed at pre- and posttreatment. Results: Veterans reported a large, significant increase in resilience posttreatment (M_diff = 14.24, t = −4.22, p < .001, d = 0.74). Greater increases in resilience were significantly associated with fewer PTSD symptoms (β = −0.37, p = .049, sr = −.36) and trauma-cued cravings (β = −0.39, p = .006, sr = −.38) posttreatment when controlling for pretreatment scores and baseline depressive symptoms. Conclusions: Results suggest that evidence-based psychotherapy for comorbid PTSD and substance use disorder may facilitate strength-based psychological growth, which may further promote sustained recovery.

KEYWORDS:

• PTSD
• substance abuse
• resilience
• psychotherapy

Disclosures

The authors declare no conflicts of interest with respect to the research, authorship, and/or publication of this article. The authors report no financial relationships with commercial interests.

Acknowledgments

This material is the result of work with resources and the use of facilities at the G.V. (Sonny) Montgomery Veterans Affairs Medical Center and is supported by the Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship Program in Mental Illness Research and Treatment, the Central Texas Veterans Health Care System, and the VISN 17 Center of Excellence for Research on Returning War Veterans. The views expressed herein are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States Government.

Portions of this paper were presented at the 31st Annual Meeting of the International Society for Traumatic Stress Studies in New Orleans, Louisiana, on November 5–7, 2015.

Additional information

Funding

No external funding sources were involved in this study.