Posttraumatic stress disorder (PTSD) and alcohol use disorder commonly co-occur. Little is known about how symptoms of one affect subsequent week symptoms of the other during the course of integrated treatment for both disorders. The sample included 107 veterans who were randomized to receive either Concurrent Treatment of PTSD and Substance Use Disorder Using Prolonged Exposure (COPE; an exposure-based trauma focused treatment) or Seeking Safety (SS; a present-focused coping skills-based treatment) and completed measures of PTSD and alcohol use at every other session. Multilevel models estimated the prospective associations between PTSD and alcohol use during treatment. Results indicated that greater PTSD symptom severity was associated with greater future alcohol use (b = 0.20, p = .024), and greater alcohol use was associated with greater future PTSD symptom severity (b = 0.13, p = .003). The effect size for PTSD symptoms to future alcohol use was larger than the reciprocal relationship. When using lagged PTSD severity to predict future drinking, results revealed that clinically significant differences in PTSD severity levels were associated with comparably large differences in drinking. Treatment condition did not moderate the effect of PTSD symptom severity on alcohol use (or the reciprocal relationship). Findings lend support to the mutual maintenance model of addiction. Integrated treatments that treat both PTSD and alcohol use may be preferential to sequential model of care where individuals are expected to achieve abstinence or reduced use prior to receiving trauma-focused treatment. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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在综合治疗过程中，创伤后应激障碍（PTSD）症状严重程度与饮酒的双向关系。

创伤后应激障碍（PTSD）和饮酒障碍通常同时发生。关于这两种疾病的综合治疗过程中，一种症状如何影响另一种症状的随后一周症状知之甚少。样本包括107名退伍军人，他们被随机分配接受PTSD的同时治疗和使用长时间暴露的物质使用障碍（COPE；一种基于暴露的创伤治疗）或寻求安全性（SS；一种基于当前应对技能的治疗），以及每隔一届会议就完成PTSD和饮酒的措施。多级模型估计了治疗期间PTSD与饮酒之间的前瞻性关联。结果表明，更高的PTSD症状严重程度与将来的饮酒习惯相关（b = 0.20，p = .024），大量饮酒与未来PTSD症状严重程度增加相关（b = 0.13，p = 0.003）。PTSD症状对将来饮酒的影响大小大于相互关系。当使用滞后的PTSD严重程度来预测将来的饮酒时，结果表明PTSD严重程度的临床显着差异与饮酒中的较大差异有关。治疗条件并未减轻PTSD症状严重程度对饮酒的影响（或相互关系）。研究结果为成瘾的相互维持模式提供了支持。治疗PTSD和酒精使用的综合治疗可能优先于序贯护理模式，在这种模式下，预期个人在接受以创伤为重点的治疗之前将获得节制或减少使用。（PsycINFO数据库记录（c）2020 APA，