Treatment responder status and time to response as a function of hazardous drinking among active duty military receiving variable-length cognitive processing therapy for posttraumatic stress disorder

Objective: A common concern is whether individuals with posttraumatic stress disorder (PTSD) and hazardous drinking will respond to PTSD treatment or need a higher dose. In a sample of active-duty military, we examined the impact of hazardous drinking on cognitive processing therapy (CPT) out- comes and whether number of sessions to reach good end-state or dropout differed by drinking status. Method: Participants included 127 service members participating in a clinical trial of variable-length CPT. The Quick Drinking Screen was used to characterize drinking. Participants were categorized as treatment responders when they reached good end-state (,20 on the PTSD Checklist for DSM–5) or nonresponders if they completed 24 sessions or 18 weeks of treatment without good end-state. Survival analyses were used to compare time to dropout or good end-state between those with and without hazardous drinking. Results: Those with hazardous drinking were as likely as those without to reach good end-state and no more likely to drop out. There were no differences in number of ses- sions to reach good end-state or dropout. On a gold-standard assessment, those with hazardous drink- ing evidenced more PTSD symptom reduction than those without. The overall proportion of participants with hazardous drinking decreased (30.7% to 18.6%), as did mean number of drinks per drinking day and drinks on the heaviest drinking day among those initially drinking hazardously. Conclusions: Results support using CPT for military personnel with PTSD and hazardous drinking and indicate that those with hazardous drinking can benefit from PTSD treatment without additional treatment sessions.