Impact of behavioral contingency management intervention on coping behaviors and PTSD symptom reduction in cocaine-addicted homeless

• Published in: Journal of traumatic stress 2007-08, Vol.20 (4), p.565-575
• Main Authors: Lester, Kristin M., Milby, Jesse B., Schumacher, Joseph E., Vuchinich, Rudolph, Person, Sharina, Clay, Olivio J.
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological; Adult; Adult and adolescent clinical studies; Anxiety disorders. Neuroses; Behavior Therapy - methods; Behavior therapy. Cognitive therapy; Biological and medical sciences; Cocaine-Related Disorders - diagnosis; Cocaine-Related Disorders - psychology; Cocaine-Related Disorders - rehabilitation; Cognitive Therapy - methods; Combined Modality Therapy; Comorbidity; Day Care, Medical; Diagnosis, Dual (Psychiatry); Female; Follow-Up Studies; Goals; Homeless Persons - psychology; Humans; Male; Medical sciences; Mental Disorders - diagnosis; Mental Disorders - psychology; Mental Disorders - rehabilitation; Middle Aged; Neuropharmacology; Pharmacology. Drug treatments; Post-traumatic stress disorder; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychopharmacology; Rehabilitation, Vocational; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - psychology; Stress Disorders, Post-Traumatic - rehabilitation; Token Economy; Treatments
• ISSN: 0894-9867; 1573-6598
• DOI: 10.1002/jts.20239

The purpose of this study was to examine changes in posttrauma symptoms among 118 homeless cocaine‐dependent adults participating in a randomly controlled trial studying effective treatments for dually diagnosed homeless individuals. Among those with trauma exposure and PTSD symptoms, the group receiving more behaviorally intensive, contingency management treatment had significantly greater reductions in PTSD symptomatology than did the group receiving less‐intensive treatment. Regression analyses revealed that greater positive distraction coping and lower negative avoidance coping at baseline, in addition to changes in avoidance coping over the 6‐month study period, were significantly related to greater symptom and severity reductions. The study provides some initial evidence of important treatment outcomes other than abstinence in addiction‐related interventions.