1. First findings of an RCT on treatment of PTSD in addiction: simultaneous or sequential treatment with EMDR, Prolonged Exposure, Imaginary Rescripting

Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) frequently co-occur. Individuals with both disorders have a more severe clinical profile than those with either disorder alone. Despite the high prevalence, patients in SUD treatment are often not assessed for PTSD or offered PTSD-focused interventions. In addition, PTSD-focused interventions have found to be less effective for this patient group than for patients without SUD.

In an RCT, we compare three PTSD treatments (EMDR, Prolonged Exposure, Imagery Rescripting) and timing of treatment (SUD/PTSD simultaneously or sequentially) in SUD patients with cooccurring PTSD. At baseline, substance use, child maltreatment, (complex) PTSD, interpersonal problems, emotion dysregulation, and trauma-related emotions were examined.

Results: Preliminary baseline data (n = 144) indicates that most participants had developed PTSD after experiencing sexual abuse (38.4%) or physical abuse (35.6%). The majority (63.3%) indicated that they suffered from PTSD before SUD, while 19.7% suffered from SUD before PTSD, and 15.0% did not know which came first. Baseline data is expected to be completed (N=204) in June 2022.

Conclusion: We will give an overview of the most recent literature on treatment of PTSD in patients with SUD and PTSD. Furthermore, we will present baseline data of our RCT on the characteristics of this complex patient group, on the prevalence of child maltreatment in this group and the association between child maltreatment and psychological factors, such as emotion dysregulation and interpersonal problems.

The study was funded by ‘Stichting tot Steun VCVGZ’ (grant number 244). The study is pre-registered at the Netherlands Trial Register under registration number NL7885 (https://www.trialregister.nl/trial/7885).