PTSD/SUD in Individuals with Physical Disabilities: Identifying Problems and Promising Interventions

Abstract

Using data from the National Comorbidity Study Replication, a national epidemiological study of mental disorders, we identified the prevalence of PTSD and SUD, the symptom presentation of these disorders, and help-seeking behaviors in relation to PTSD and SUD among individuals with physical disabilities. Results indicated that individuals with physical disabilities exhibited higher rates of PTSD, SUD, and comorbid PTSD/SUD, reported more lifetime trauma events, and endorsed more recent, severe PTSD symptoms than non-disabled individuals. No significant pattern of differences was noted for SUD symptom presentation, nor for receipt of lifetime and pastyear PTSD and SUD treatment. METHOD • Data from the 2001 – 2003 administration of the National Comorbidity Study Replication (NCS-R), a national epidemiological study of mental disorders • Variables analyzed: • Demographics; DSM-IV PTSD/SUD diagnoses; characteristics of trauma and substance use; help-seeking • Physical disability status = “Do you have any of the following conditions: Any physical handicap or disability?” • Weighting/stratification/clustering applied as recommended by NCS-R analysts ABSTRACT This secondary analysis investigated the impact of Seeking Safety on reducing PTSD symptoms in a sample of women with physical disabilities versus non-disabled women. Seeking Safety is an evidence-based manualized therapy for PTSD and SUD, and provides clients psychoeducation and coping skills to manage symptoms of PTSD and SUD. As part of the National Institute on Drug Abuse Clinical Trials Network, 353 participants were randomly assigned to either Seeking Safety or Women’s Health Education group therapy conducted in community-based substance abuse treatment programs. Participants with physical disabilities experienced sustained reductions in PTSD symptoms when treated with Seeking Safety but not Women’s Health Education. SUBJECTS • 10.1% of the sample had a physical disability, weighted n = 491 (of n = 4,883) • Subsample of individuals with physical disabilities were: • 8 years older • Reported a lower yearly income • More likely to be divorced/separated/ widowed • Less likely to have a high school diploma • Less likely to be employed • These disparate variables were entered as covariates in all analyses