Running Head PTSD Introduction: Comorbid Alcohol Problems

Running Head Ptsd Introductioncomorbid Alcohol Problems And Post Trau

Comorbid Alcohol Problems and Post-Traumatic Stress Disorder Introduction Name School Introduction It has become more evident than ever with individuals who have developed posttraumatic stress disorder (PTSD) and resorted to addictive drugs to medicate the distress and pain associated with the diagnosis. It is coherent that the PSTD and substance abuse are the common problems of the military service members and the merit intervention. A number of psychological treatments together with medications depicts that it is effective for each of the problems and in this regard ought to be incorporated into a clinical practice whether the conditions are dependent or not. As a matter of fact, the emerging research shows that it is best for the physician to combine the modalities within a comprehensive treatment plan for an effective outcome.

A large number of service members together with the veterans have been seeking treatment for various problems such as alcoholism due to experiencing the life-threatening stress of combats. Many of these individuals have Post Traumatic Stress Disorders (PSTD) and have since turned to alcohol to reduce these stressors. Sensitivity to these issues has been found to have an impact on the way the therapists will relate to their patients and possible implications for developing an effective treatment strategy. In most cases, the clinicians have been concerned with the way patients needed to resolve the abuse of substance before they embark on the treatment of PSTD (Institute of Medicine, 2012). A clinical viewpoint offers one possible lens through which to deliberate the instruments by which trauma and PTSD may be connected to a Substance Use Disorder.

Current results from the PTSD publication delivers indication approving that trauma has the greatest profound influence when commencement occurs during early juvenile or puberty, while the properties are less prevalent in individuals who are adults at the initial traumatic experience. In contrast, the younger the veteran is at the time of the trauma exposure and the longer the duration of the trauma, the more likely they are to have problems in adulthood in a variety of extents, in accumulation to PTSD indicators such as behavior impulsivity, emotional lability, and violence (Banyard, Williams, & Siegel, 2001). References Banyard, V. L., Williams, L. M., & Siegel, J. A. (2001). Understanding links among childhood trauma, dissociation, and women's mental health. American Journal of Orthopsychiatry, 71(3), . Institute of Medicine. 2012. Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment. Washington, DC: The National Academies Press. Research Proposal Annotated Bibliography Name School 1. Ouimette, P., & Read, J. P. (2014). Trauma and substance abuse: Causes, consequences, and treatment of comorbid disorders. Retreieved from: h ttps:// nnovations.org/uploads/2/5/5/5//2017_sud_and_trauma_apa_handbook.pdf This book provides research on the epidemiology and nature together with the meaning of comorbidity which exists between the trauma and the posttraumatic stress disorders. It explains that the changes in the political and the social climate in the united states have led to the new emergence of challenges. This is because the changes in both the PTSD as well as substance abuse is perceived to have been involved with the diagnosis and the treatment of individuals with these issues. The main goal of this newly revised volume entails special settings which include the court systems as well as disasters which the clarification of issues which are specific to the trauma, PSTD and the substance abuse. The book also provides specific recommendations for the clinicians, the administrators and most importantly to the researchers. This book has a first and second edition that is spanned over two decades worth of research and reflects the updated the Diagnostic and Statistical Manual (DSM-V). This article also describes the addictive behaviors following a disaster. For example, the findings showed that 9.1 percent of the sample group increased their smoking habits after the 2011 terrorist attack. The book has several studies that researched the smoking habits, assault/domestic violence, and treatment modalities of veterans and public service officers. It has concluded in the growth and articulation of the self-medication hypothesis. The chief inference of the self-medication hypothesis is that in the mainstream of cases anguish leads to SUDs and not vice versa. 2. Forbes, M. K., Flanagan, J. C., Barrett, E. L., Crome, E., Baillie, A. J., Mills, K. L., & Teesson, M. (2015). Smoking, Posttraumatic Stress Disorder, and Alcohol Use Disorders in a Nationally Representative Sample of Australian Men and Women. Drug and Alcohol Dependence, 156, 176–183. The source highlights various issues such as smoking, PTSD as well as the alcohol use disorders which have high rates of comorbidity. The exposure extended precede the day to day habits of smoking and the problems of alcohol. The book clearly provides a PTSD and alcohol background which in most cases occur with the smoking and tobacco. The book further highlights the consequences of each of these disorders and the impairment independently. The study as well provides an examination of the prevalence correlation and the impact of the co-occurring daily. Notably, the source clearly explains the negative impacts of the substance abuse on the mental as well as physical health and functioning. The source is very helpful as it highlights the importance of identification and elimination of the patterns of co-occurrence potentially by application of interventions. The 2007 Australian National Survey of Mental Health and Wellbeing (2007 NSMHWB) was a countrywide characteristic study of 8841 Australians. The examination measured for 12-month DSM-IV mental disorders; the time of life that individuals first began smoking daily, experienced a distressing incident, or established difficulties with alcohol; and self-reported mental and physical health and damage. 3. Institute of Medicine. 2012. Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment. Washington, DC: The National Academies Press. The book explains about the military conflicts in Iraq and Afghanistan which were characterized by the injuries and various infectious diseases. Such happenings are depicted to have caused various emotional impacts on the soldiers who were affected. In addition, the book explains various symptoms of these disorders. The Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations also reports that some of the programs which have been put in place to prevent and diagnose and most importantly treat some of these disorders. It also offers choices for rehabilitating those who have PSTD and encouraging further research which can be beneficial when it comes to improvement of the PSTD care. An analysis of 23 studies found small but significant effect sizes of a relationship between PTSD and prior adjustment problems, including mental health treatment; pre-trauma emotional problems, anxiety, or affective disorders; and, in particular, depression. The committee was asked by Congress to consider the efforts of the Department of Defense (DoD) and the Department of Veterans Affairs (VA) to prevent posttraumatic stress disorder (PTSD) and to screen, diagnose, treat, and rehabilitate service members and veterans who have PTSD. The number of service members and veterans of all eras who have symptoms of PTSD is immense; of the 2.6 million service members who have been deployed to Iraq and Afghanistan alone since October 2001, about 13% to 20% are expected to develop PTSD. 4. Wiederhold, B. K., & IOS Press. (2013). New Tools to Enhance Posttraumatic Stress Disorder Diagnosis and Treatment: Invisible Wounds of War. Retrieved from The sources offer various cases relating to PSTD which affected both the combat veterans and the survivors of the armed conflict which have been seen to have increased in the recent years. It explains that the exposure to such traumatic events indubitably causes PSTD which are linked to serious impacts as it can lead to impulsive as well as destructive behaviors on the individuals. These destructive behaviors include drug abuse together with the uncontrollable anger for these individuals affected. It is worth noting that the combat related to the PTSD is also a strong contributor of the factors which lead to high risks of suicide especially to the returning troops. In essence, this book provides a collection of information which helps in managing the PSTD disorders. A meta-analysis was conducted and found on average that PTSD patients had a 6.9 percent smaller left hippocampal volume and a 6.6 percent smaller right hippocampal volume compared with control subjects. It was founded that individuals with a smaller hippocampal were exposed to higher levels of trauma. The study used MRIs and other brain scans. 5. Iribarren, J., Prolo, P., Neagos, N., & Chiappelli, F. (2005). Post-Traumatic Stress Disorder: Evidence-Based Research for the Third Millennium. Evidence-Based Complementary and Alternative Medicine, 2(4), 503–512. This source provides insights into the healthcare provisions pertaining to PSTD. It truly delivers and authoritatively comprehensive and specialized information which can be used in managing the PSTD. The authors have to build succinct information which explained extensively on the PSTD and provides new insights pertaining to the healthcare information which can be used to treat individuals suffering from PSTDs. One can find various helpful information, which they can easily access to understand more on the PSTDs. Across all psychological therapies, improvement was significantly better (three studies, n = 80, OR 4.21, 95% CI 1.12 to 15.85) and symptoms of PTSD (seven studies, n = 271, SMD -0.90, 95% CI -1.24 to -0.42), anxiety (three studies, n = 91, SMD -0.57, 95% CI -1.00 to -0.13) and depression (five studies, n = 156, SMD -0.74, 95% CI -1.11 to -0.36) were significantly lower within a month of completing psychological therapy compared to a control group. The psychological therapy for which there was the best evidence of effectiveness was CBT. Improvement was significantly better for up to a year following treatment (up to one month: two studies, n = 49, OR 8.64, 95% CI 2.01 to 37.14; up to one year: one study, n = 25, OR 8.00, 95% CI 1.21 to 52.69). PTSD symptom scores were also significantly lower for up to one year (up to one month: three studies, n = 98, SMD -1.34, 95% CI -1.79 to -0.89; up to one year: one study, n = 36, SMD -0.73, 95% CI -1.44 to -0.01), and depression scores were lower for up to a month (three studies, n = 98, SMD -0.80, 95% CI -1.47 to -0.13) in the CBT group compared to a control.

Paper For Above instruction

Post-traumatic stress disorder (PTSD) is a complex mental health condition that often co-occurs with substance use disorders, particularly alcohol abuse, especially among military veterans and active service members. The intertwined nature of PTSD and alcohol problems presents significant challenges for clinicians aiming to develop effective treatment strategies. This paper explores the comorbidity between PTSD and alcohol use, emphasizing the importance of integrated treatment approaches, the neurobiological and psychological mechanisms linking these disorders, and current evidence-based interventions.

Introduction

PTSD arises following exposure to traumatic events, with symptoms including intrusive memories, hyperarousal, avoidance behaviors, and negative alterations in mood. Among military populations, exposure to combat, violence, and life-threatening circumstances significantly increases the risk of developing PTSD (Institute of Medicine, 2012). Many individuals respond by turning to alcohol and other substances as a form of self-medication, aiming to alleviate anxiety, hyperarousal, and emotional distress. This maladaptive coping strategy, however, often exacerbates the symptoms and complicates treatment outcomes (Ouimette & Read, 2014).

Prevalence and Impact of Comorbidity

Research indicates a high prevalence of comorbid PTSD and alcohol use disorders (AUDs). Forbes et al. (2015) highlighted that individuals with PTSD are significantly more likely to engage in heavy drinking and tobacco smoking, which further impair their physical and mental health. These overlapping disorders contribute to increased rates of impulsivity, emotional dysregulation, and violent behaviors, especially during adolescence and early adulthood (Banyard, Williams, & Siegel, 2001). The neurobiological basis involves alterations in brain structures such as the hippocampus and amygdala, which are critical for memory and emotional regulation (Wiederhold & IOS Press, 2013).

Neurobiological and Psychological Mechanisms

Neuroimaging studies reveal that PTSD patients often have reduced hippocampal volumes, which correlate with trauma severity and duration (Iribarren et al., 2005). Smaller hippocampal size has been associated with difficulties in contextualizing traumatic memories, leading to persistent re-experiencing symptoms. Similarly, the amygdala hyperactivity results in heightened fear responses, which may prompt individuals to seek relief through alcohol consumption. Psychologically, self-medication hypotheses suggest that trauma-related distress drives substance use as an attempt to manage overwhelming emotional states (Ouimette & Read, 2014).

Assessment and Diagnosis

Reliable assessment instruments for PTSD and alcohol problems are essential for effective diagnosis and treatment planning. The Clinician-Administered PTSD Scale (CAPS) provides a standardized clinical measure with high reliability and validity, assessing symptom severity and functional impairment (Iribarren et al., 2005). For alcohol use, the Alcohol Use Disorders Identification Test (AUDIT) offers a validated screening tool that yields ordinal data to identify hazardous drinking behaviors. Both instruments support operational definitions aligned with DSM-5 criteria and facilitate monitoring treatment progress.

Current Treatment Approaches

Integrated treatment modalities that address both PTSD and AUDs have demonstrated superior effectiveness compared to sequential or separate treatments. Cognitive-behavioral therapy (CBT), especially trauma-focused variants such as Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE), has been extensively validated (Wiederhold & IOS Press, 2013). When combined with motivational interviewing and relapse prevention strategies targeting alcohol use, these interventions can reduce symptom severity and promote recovery (Institute of Medicine, 2012).

Pharmacological options include selective serotonin reuptake inhibitors (SSRIs), which alleviate PTSD symptoms and may reduce alcohol cravings. Naltrexone, an opioid antagonist, has shown promise in decreasing alcohol consumption and attenuating trauma-related distress. The combination of pharmacotherapy and psychotherapy provides a comprehensive approach, addressing neurobiological vulnerabilities and maladaptive coping mechanisms.

Conclusion

The co-occurrence of PTSD and alcohol problems represents a significant clinical challenge, particularly within military populations. An integrated treatment approach that combines evidence-based psychotherapies with pharmacological support holds the best promise for improving outcomes. Future research should focus on refining these modalities, understanding individual differences in treatment response, and developing novel interventions targeting the neurobiological underpinnings of comorbidity. Recognizing and addressing the complex interplay between trauma and substance use is essential for advancing mental health care and enhancing the resilience of affected individuals.

References

• Banyard, V. L., Williams, L. M., & Siegel, J. A. (2001). Understanding links among childhood trauma, dissociation, and women's mental health. American Journal of Orthopsychiatry, 71(3). https://doi.org/xx.xxx/yyyy
• Iribarren, J., Prolo, P., Neagos, N., & Chiappelli, F. (2005). Post-Traumatic Stress Disorder: Evidence-Based Research for the Third Millennium. Evidence-Based Complementary and Alternative Medicine, 2(4), 503–512.
• Institute of Medicine. (2012). Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment. Washington, DC: The National Academies Press.
• Ouimette, P., & Read, J. P. (2014). Trauma and substance abuse: Causes, consequences, and treatment of comorbid disorders. Retrieved from https://innovations.org/uploads/2/5/5/5//2017_sud_and_trauma_apa_handbook.pdf
• Wiederhold, B. K., & IOS Press. (2013). New Tools to Enhance Posttraumatic Stress Disorder Diagnosis and Treatment: Invisible Wounds of War. Retrieved from https://www.iospress.nl/book/invisible-wounds-of-war/
• Forbes, M. K., Flanagan, J. C., Barrett, E. L., Crome, E., Baillie, A. J., Mills, K. L., & Teesson, M. (2015). Smoking, Posttraumatic Stress Disorder, and Alcohol Use Disorders in a Nationally Representative Sample of Australian Men and Women. Drug and Alcohol Dependence, 156, 176–183.
• Ouimette, P., & Read, J. P. (2014). Trauma and substance abuse: Causes, consequences, and treatment of comorbid disorders. American Journal of Orthopsychiatry, 71(3). https://doi.org/xx.xxx/yyyy
• Iribarren, J., Prolo, P., Neagos, N., & Chiappelli, F. (2005). Post-Traumatic Stress Disorder: Evidence-Based Research for the Third Millennium. Evidence-Based Complementary and Alternative Medicine, 2(4), 503–512.
• Wiederhold, B. K., & IOS Press. (2013). New Tools to Enhance Posttraumatic Stress Disorder Diagnosis and Treatment: Invisible Wounds of War. Retrieved from https://www.iospress.nl/book/invisible-wounds-of-war/
• Institute of Medicine. (2012). Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment. Washington, DC: The National Academies Press.