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Article ; Online: MORE Is Less Pain and Less Opioid Misuse: A Mindful Remedy.

Killeen, Therese K / Brewerton, Timothy D

2023 Volume 181, Issue 2, Page(s) 89–91

MeSH term(s)	Humans ; Opioid-Related Disorders/prevention & control ; Opioid-Related Disorders/drug therapy ; Analgesics, Opioid/adverse effects ; Pain/drug therapy ; Mindfulness
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2023-12-29
Publishing country	United States
Document type	Editorial
ZDB-ID	280045-7
ISSN	1535-7228 ; 0002-953X
ISSN (online)	1535-7228
ISSN	0002-953X
DOI	10.1176/appi.ajp.20231001
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Article ; Online: Women with PTSD and Substance Use Disorders in a Research Treatment Study: A Comparison of those with and without the Dissociative Subtype of PTSD.

Killeen, Therese K / Brewerton, Timothy D

Journal of trauma & dissociation : the official journal of the International Society for the Study of Dissociation (ISSD)

2022 Volume 24, Issue 2, Page(s) 229–240

Abstract: Significant differences in clinical features have been reported in women with substance use disorders (SUDs) between those with the dissociative subtype of posttraumatic stress disorder (D-PTSD) compared to those without, namely more severe trauma ... ...

Abstract	Significant differences in clinical features have been reported in women with substance use disorders (SUDs) between those with the dissociative subtype of posttraumatic stress disorder (D-PTSD) compared to those without, namely more severe trauma histories, PTSD symptoms, and general psychopathology. This presentation reports on a group of 88 women with PTSD and SUD taking part in a research treatment study. All women were assessed using the Clinician Administered PTSD Scale for DSM-5 (CAPS-5) and were categorized into those with (n = 23, 26%) and without (n = 65, 74%) D-PTSD. Assessments for SUDs were via the Multi-International Neuropsychiatric Inventory, Seventh Version (MINI-7). Compared to those without D-PTSD, those with D-PTSD had significantly higher CAPS-5 scores (50.5 ± 9.9 v. 39.6 ± 8.8), greater number of PTSD symptoms (16.4 ± 2.6 v. 14.2 ± 2.4), more alcohol use disorder (AUD) (65.2% v. 30.8%), and more non-cocaine stimulant use disorder (34.8% v. 12.3%). No significant differences were found for other SUDs. These women with SUDs and D-PTSD have higher degrees of PTSD severity as well as unique clinical presentations. Future research is needed to explore the significance of these findings for clinical assessment and treatment.
MeSH term(s)	Female ; Humans ; Alcoholism ; Dissociative Disorders/psychology ; Stress Disorders, Post-Traumatic/psychology ; Substance-Related Disorders/therapy
Language	English
Publishing date	2022-10-20
Publishing country	England
Document type	Journal Article
ISSN	1529-9740
ISSN (online)	1529-9740
DOI	10.1080/15299732.2022.2136327
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Article ; Online: Predictors of Treatment Completion among Women Receiving Integrated Treatment for Comorbid Posttraumatic Stress and Substance Use Disorders.

Killeen, Therese K / Wen, Chun-Che / Neelon, Brian / Baker, Nathanial

Substance use & misuse

2023 Volume 58, Issue 4, Page(s) 500–511

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Humans ; Female ; Stress Disorders, Post-Traumatic/complications ; Stress Disorders, Post-Traumatic/epidemiology ; Stress Disorders, Post-Traumatic/therapy ; Comorbidity ; Mindfulness ; Secondary Prevention ; Substance-Related Disorders/complications ; Substance-Related Disorders/epidemiology ; Substance-Related Disorders/therapy ; Treatment Outcome
Language	English
Publishing date	2023-01-27
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1310358-1
ISSN	1532-2491 ; 1082-6084
ISSN (online)	1532-2491
ISSN	1082-6084
DOI	10.1080/10826084.2023.2170183
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Article ; Online: Efficacy of mindfulness-based relapse prevention in a sample of veterans in a substance use disorder aftercare program: A randomized controlled trial.

Killeen, Therese K / Baker, Nathaniel L / Davis, Lori L / Bowen, Sarah / Brady, Kathleen T

Journal of substance use and addiction treatment

2023 Volume 152, Page(s) 209116

Abstract: Background: Complementary integrative medicine, such as mindfulness-based interventions, (MBI) have demonstrated efficacy in the treatment of depression, anxiety, substance use disorders (SUDs), and pain. Mindfulness-based relapse prevention (MBRP) is ... ...

Abstract	Background: Complementary integrative medicine, such as mindfulness-based interventions, (MBI) have demonstrated efficacy in the treatment of depression, anxiety, substance use disorders (SUDs), and pain. Mindfulness-based relapse prevention (MBRP) is an aftercare intervention targeting SUD relapse that integrates cognitive-behavioral relapse prevention and mindfulness meditation practices, raising awareness of substance use triggers and reactive behavioral patterns. This study evaluated the efficacy of MBRP in reducing relapse in veterans following completion of an SUD treatment program. Methods: This study was a two-site, randomized controlled trial comparing MBRP to 12-step facilitation (TSF) aftercare in military veterans following completion of intensive treatment for SUDs. The 8 weeks of 90-minute, group-based MBRP or TSF sessions were followed by 3-, 6- and 10-month follow-up periods with assessments of alcohol/substance use and secondary outcomes of depression, anxiety, and mindfulness. Results: Forty-seven percent of veterans attended ≥75 % of sessions. Veterans in both the MBRP and TSF aftercare groups maintained reductions in alcohol and illicit substance use during the aftercare treatment. Nineteen participants (11 %; 19/174) reported returning to alcohol use during the study treatment period and the study found no difference between study groups [MBRP: 9 % vs. TSF 13 %; p = 0.42]. Thirteen participants (7.5 %; 13/174) reported a return to illicit substance use during study treatment [MBRP: 5.4 % vs. TSF 10.3 % p = 0.34]. The number of days of drinking and illicit substance use was not different between groups (alcohol, p = 0.53; illicit substance use, p = 0.28). Conclusion: Although retention in treatment limits interpretation of the findings, both MBRP and TSF were effective in maintenance of treatment gains following an intensive treatment program for veterans with SUDs. Future studies should focus on strategies to improve treatment participation.
MeSH term(s)	Humans ; Mindfulness ; Veterans ; Secondary Prevention ; Aftercare ; Neoplasm Recurrence, Local ; Substance-Related Disorders/prevention & control ; Ethanol
Chemical Substances	Ethanol (3K9958V90M)
Language	English
Publishing date	2023-06-25
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ISSN	2949-8759
ISSN (online)	2949-8759
DOI	10.1016/j.josat.2023.209116
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Article ; Online: Efficacy of mindfulness-based relapse prevention in veterans with substance use disorders: Design and methodology of a randomized clinical trial.

Brady, Kathleen T / Killeen, Therese / Baker, Nathaniel L

Contemporary clinical trials

2021 Volume 105, Page(s) 106393

Abstract: Mindfulness based interventions have been shown to be efficacious in treating depression, anxiety, pain and substance use disorders (SUDs). Mindfulness-Based Relapse Prevention (MBRP) is an intervention that integrates cognitive-behavioral relapse ... ...

Abstract	Mindfulness based interventions have been shown to be efficacious in treating depression, anxiety, pain and substance use disorders (SUDs). Mindfulness-Based Relapse Prevention (MBRP) is an intervention that integrates cognitive-behavioral relapse prevention and mindfulness meditation practices, in an 8-week, manualized group intervention designed to treat SUDs by helping patients regulate negative emotional states and reactive behavior. This paper describes the rationale, study design and methodology of a two-site, randomized controlled trial comparing MBRP to 12-Step Facilitation (TSF) in military Veterans following completion of intensive outpatient treatment for SUDs. The 8 weeks of 90-min, group-based MBRP or TSF sessions are followed by 3-, 6- and 10-month follow-up period with assessments of alcohol/drug use, quality of life, depression, anxiety, mindfulness and other functional outcomes, such as employment. The primary hypothesis is that MBRP will be significantly better than TSF in promoting recovery and prevention of relapse to substance use in a military Veteran population. The secondary hypothesis is that MBRP will lead to greater improvements in quality of life, depression/anxiety, and functional outcomes, such as employment. This study is designed to provide information about the use of group-based MBRP as a relapse prevention strategy for military Veterans who have completed an intensive SUD clinical treatment program. Clinical Trial Identifier: NCT02326363.
MeSH term(s)	Humans ; Mindfulness ; Neoplasm Recurrence, Local ; Quality of Life ; Secondary Prevention ; Substance-Related Disorders/prevention & control ; Veterans
Language	English
Publishing date	2021-04-20
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2182176-8
ISSN	1559-2030 ; 1551-7144
ISSN (online)	1559-2030
ISSN	1551-7144
DOI	10.1016/j.cct.2021.106393
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Article ; Online: Examining the role of social support in treatment for co-occurring substance use disorder and posttraumatic stress disorder.

Jarnecke, Amber M / Saraiya, Tanya C / Brown, Delisa G / Richardson, James / Killeen, Therese / Back, Sudie E

Addictive behaviors reports

2022 Volume 15, Page(s) 100427

Abstract: Objective: Social support may be a critical mechanism in the treatment of co-occurring substance use disorder (SUD) and posttraumatic stress disorder (PTSD). However, no studies have examined how social support changes as a function of treatment or ... ...

Abstract	Objective: Social support may be a critical mechanism in the treatment of co-occurring substance use disorder (SUD) and posttraumatic stress disorder (PTSD). However, no studies have examined how social support changes as a function of treatment or predicts treatment outcome in a Veteran population with co-occurring SUD and PTSD. Method: The current study is a secondary analysis that examined social support over the course of treatment for co-occurring SUD and PTSD (N = 81). Analyses were conducted to examine if a) social support predicts change in substance use and PTSD symptoms, respectively, over the course of treatment and during follow-up, and b) substance use and PTSD symptoms, respectively, predicts change in social support over treatment and during follow-up. Results: The findings revealed that between-person social support moderated decreases in substance use ( Conclusions: The findings highlight the critical role of social support during treatment in enhancing outcomes for individuals with co-occurring SUD and PTSD.
Language	English
Publishing date	2022-04-11
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2831558-3
ISSN	2352-8532 ; 2352-8532
ISSN (online)	2352-8532
ISSN	2352-8532
DOI	10.1016/j.abrep.2022.100427
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Article ; Online: Risky Sexual Behaviors and Condom Use Barriers in Iranian Women with Substance Use Disorders.

Khoei, Effat Mergati / Rezaei, Zahed / Mohraz, Minoo / Bayat, Alireza / Ghanbarpour, Fatemeh / Killeen, Therese / Korte, Jeffrey E

Iranian journal of public health

2023 Volume 52, Issue 8, Page(s) 1673–1681

Abstract: Background: Scant information exists on Iranian women's protective behaviors mainly constant condom use. Inconsistent condom use seems prevalent among women with substance use problems. We aimed to investigate risky sexual behaviors (RSBs) and condom ... ...

Abstract	Background: Scant information exists on Iranian women's protective behaviors mainly constant condom use. Inconsistent condom use seems prevalent among women with substance use problems. We aimed to investigate risky sexual behaviors (RSBs) and condom use barriers in Iranian women with substance use disorders (SUDs). Methods: In our cross-sectional study, we recruited 300 women who sought treatments for their SUDs from the active outpatient drug free (ODF) and Methadone Maintenance Therapy (MMT) centers in Tehran, Iran during 2017-2021. We used three batteries including demographic questionnaire, the Risky Sexual Behavior Questionnaire (RSBQ); and the Condom Barriers Scale (CBS). The statistical software R, analysis of variance post hoc and multivariate analysis of variance (MANOVA) logistic regression tests were used in data analysis. Results: The majority reported at least one lifetime experience of RSBs. Our results show that only 22% of the participants 'always' use condom in their sexual encounters. The lowest and highest subscale scores of the CBS were related to Sexual Experience (SE) (2.47 ± 0.86) and access/availability structure (3.52 ± 0.7), respectively. RSBs had negative significant association with Partner Barrier (PB) subscale scores (OR = 0.4; 95% CI: 0.22 to 0.73) and effect on SE subscale scores (OR= 0.54; 95% CI: 0.31 to 0.94). Conclusion: RSBs was prevalent among our study population. RSBs and condom use barriers are significantly interwoven. The condom use barriers were highly associated with the types of sexual encounters such as group sex or casual sexual relations than specific mean of sexual performance (i.e. anal sex). Gender-specific RSBs, STIs/HIV/AIDS prevention program is recommended for women with SUDs.
Language	English
Publishing date	2023-09-25
Publishing country	Iran
Document type	Journal Article
ISSN	2251-6093 ; 0304-4556
ISSN (online)	2251-6093
ISSN	0304-4556
DOI	10.18502/ijph.v52i8.13405
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Article ; Online: The role of posttraumatic guilt and anger in integrated treatment for PTSD and co-occurring substance use disorders among primarily male veterans.

Saraiya, Tanya C / Badour, Christal L / Jones, Alyssa C / Jarnecke, Amber M / Brown, Delisa G / Flanagan, Julianne C / Killeen, Therese K / Back, Sudie E

Psychological trauma : theory, research, practice and policy

2022 Volume 15, Issue 8, Page(s) 1293–1298

Abstract: Objective: PTSD and substance use disorders (SUD) frequently co-occur among veterans. Integrated exposure-based treatments, such as Concurrent Treatment of PTSD and SUD Using Prolonged Exposure (COPE), are efficacious in reducing PTSD and SUD symptoms ... ...

Abstract	Objective: PTSD and substance use disorders (SUD) frequently co-occur among veterans. Integrated exposure-based treatments, such as Concurrent Treatment of PTSD and SUD Using Prolonged Exposure (COPE), are efficacious in reducing PTSD and SUD symptoms and posttraumatic emotions. This study examines whether guilt and anger (a) decreased in a randomized clinical trial comparing COPE with Relapse Prevention (RP) therapy for SUD and (b) mediated PTSD and SUD symptom reductions or vice versa. Method: Veterans (90.1% men) diagnosed with PTSD and SUD were randomized to 12 sessions of COPE ( Results: Guilt ( Conclusions: Among veterans, integrated, trauma-focused treatments may be associated with greater guilt (directly) and anger (indirectly) reductions due to processing trauma. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
MeSH term(s)	Humans ; Male ; Female ; Veterans/psychology ; Stress Disorders, Post-Traumatic/psychology ; Implosive Therapy ; Comorbidity ; Anger ; Guilt ; Substance-Related Disorders/complications
Language	English
Publishing date	2022-01-13
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2497028-1
ISSN	1942-969X ; 1942-9681
ISSN (online)	1942-969X
ISSN	1942-9681
DOI	10.1037/tra0001204
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Article ; Online: Patient- and therapist-rated alliance predict improvements in posttraumatic stress disorder symptoms and substance use in integrated treatment.

Saraiya, Tanya C / Jarnecke, Amber M / Bauer, Alexandria G / Brown, Delisa G / Killeen, Therese / Back, Sudie E

Clinical psychology & psychotherapy

2022 Volume 30, Issue 2, Page(s) 410–421

Abstract: Objective: Concurrent Treatment of Posttraumatic Stress Disorder (PTSD) and Substance Use Disorders Using Prolonged Exposure (i.e., COPE) is an efficacious, integrated, psychotherapy that attends to PTSD and substance use disorders simultaneously. No ... ...

Abstract	Objective: Concurrent Treatment of Posttraumatic Stress Disorder (PTSD) and Substance Use Disorders Using Prolonged Exposure (i.e., COPE) is an efficacious, integrated, psychotherapy that attends to PTSD and substance use disorders simultaneously. No study has examined how therapeutic alliance functions during the provision of COPE and how this compares to non-integrated treatments, such as relapse prevention (RP) for substance use disorders. Understanding the role of alliance in COPE versus RP could inform treatment refinement and ways to enhance treatment outcomes. Methods: Participants (N = 55 veterans) were randomized to 12, individual, weekly sessions of COPE or RP in a randomized clinical trial. Piecewise linear mixed effect models examined how mid-treatment (1) patient-rated alliance, (2) therapist-rated alliance, and (3) the convergence between patient- and therapist-rated alliance as measured by a difference score predicted reductions in PTSD symptoms and substance use across treatment and follow-up periods. Results: Both patient- and therapist-rated alliance predicted reductions in PTSD symptoms in COPE. Higher patient-rated alliance predicted lower percent days using substances in RP. Difference score models showed higher patient-rated alliance relative to therapist-rated alliance scores predicted symptom reductions in COPE whereas higher therapist-rated alliance scores relative to patient-rated alliance scores predicted symptom reductions in RP. Discussion: Preliminary findings show a unique relationship between the rater of the alliance and treatment modalities. Patient-rated alliance may be important in trauma-focused, integrated treatments whereas therapist-rated alliance may be more important in skills-focused, substance use interventions.
MeSH term(s)	Humans ; Stress Disorders, Post-Traumatic/therapy ; Substance-Related Disorders/therapy ; Treatment Outcome ; Therapeutic Alliance ; Implosive Therapy
Language	English
Publishing date	2022-12-16
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	1169313-7
ISSN	1099-0879 ; 1063-3995
ISSN (online)	1099-0879
ISSN	1063-3995
DOI	10.1002/cpp.2810
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Article ; Online: Project harmony: A systematic review and network meta-analysis of psychotherapy and pharmacologic trials for comorbid posttraumatic stress, alcohol, and other drug use disorders.

Hien, Denise A / Papini, Santiago / Saavedra, Lissette M / Bauer, Alexandria G / Ruglass, Lesia M / Ebrahimi, Chantel T / Fitzpatrick, Skye / López-Castro, Teresa / Norman, Sonya B / Killeen, Therese K / Back, Sudie E / Morgan-López, Antonio A

Psychological bulletin

2023 Volume 150, Issue 3, Page(s) 319–353

Abstract: We conducted a systematic review and network meta-analyses (NMA) of psychotherapy and pharmacologic treatments for individuals with co-occurring posttraumatic stress disorder (PTSD) and alcohol or other drug use disorder (AOD). A comprehensive search ... ...

Abstract	We conducted a systematic review and network meta-analyses (NMA) of psychotherapy and pharmacologic treatments for individuals with co-occurring posttraumatic stress disorder (PTSD) and alcohol or other drug use disorder (AOD). A comprehensive search spanning 1995-2019 yielded a pool of 39 studies for systematic review, including 24 randomized controlled trials for the NMA. Study interventions were grouped by target of treatment (PTSD + AOD, PTSD-only, and AOD-only) and approach (psychotherapy or medication). Standardized mean differences (SMD) from the NMA yielded evidence that at the end of treatment, integrated, trauma-focused therapy for PTSD + AOD was more effective at reducing PTSD symptoms than integrated, non-trauma-focused therapy (SMD = -0.30), AOD-focused psychotherapy (SMD = -0.29), and other control psychotherapies (SMD = -0.43). End-of-treatment alcohol use severity was less for AOD medication compared to placebo medication (SMD = -0.36) and trauma-focused therapy for PTSD + placebo medication (SMD = -0.67), and less for trauma-focused psychotherapy + AOD medication compared to PTSD medication (SMD = -0.53), placebo medication (SMD = -0.50), and trauma-focused psychotherapy + placebo medication (SMD = -0.81). Key limitations include the small number of studies in the NMA for pharmacologic treatments and the lack of demographic diversity apparent in the existing literature. Findings suggest room for new studies that can address limitations in study sample composition, sample sizes, retention, and apply new techniques for conducting comparative effectiveness in PTSD + AOD treatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
MeSH term(s)	Humans ; Network Meta-Analysis ; Psychotherapy/methods ; Stress Disorders, Post-Traumatic/epidemiology ; Stress Disorders, Post-Traumatic/therapy ; Substance-Related Disorders/epidemiology ; Substance-Related Disorders/therapy
Language	English
Publishing date	2023-11-16
Publishing country	United States
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	1321-3
ISSN	1939-1455 ; 0033-2909
ISSN (online)	1939-1455
ISSN	0033-2909
DOI	10.1037/bul0000409
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