Clinician's commentary to accompany "Clinical, operational, and financial evaluation practices in integrated behavioral health care".

Presents a clinician's commentary to accompany the article "Clinical, operational, and financial practices in integrated behavioral health care" by A. R. Muse et al (see record 2022-60013-001). In this commentary, the authors address four questions: (1) How does this article, written by researchers, resonate with your experience as a clinician? (2) What Is one thing you might do differently in your practice after reading this article? (3) What factors might facilitate or hinder the uptake/implementation of ideas in this piece? What is one unanswered question that you would like to see pursued as a follow-up to this article? (5) (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Sexual Harassment and Assault During Deployment: Associations with Treatment Outcomes Among Veterans with Co-occurring PTSD and SUD.

Sexual trauma is common and increases risk for posttraumatic stress disorder (PTSD), substance use disorders (SUD), and depression among veterans. Limited research has examined the impact of sexual harassment and assault during deployment on treatment outcomes among veterans with co-occurring PTSD and SUD. The current study examined frequency of exposure to sexual harassment and assault during deployment as a predictor of treatment outcomes among a primarily male sample of U.S military veterans diagnosed with current PTSD and SUD. A secondary analysis was performed using data from a randomized clinical trial examining the efficacy of Concurrent Treatment of PTSD and Substance Use Disorders using Prolonged Exposure (COPE) compared to Relapse Prevention (RP). Data from 69 veterans (91.3% male) who were deployed while in the service were analyzed using mixed models to determine whether frequency of exposure to sexual harassment and assault during deployment impacted changes in PTSD symptom severity, percent days using substances, and depressive symptoms during treatment. Over one-third of the sample (36.2%) reported exposure to sexual harassment and/or assault during deployment. Frequency of exposure to sexual harassment and assault during deployment was not a predictor of treatment outcome in any of the models, suggesting a similar response to treatment among those with varying frequency of exposure to sexual harassment and assault during deployment. Veterans with co-occurring PTSD and SUD who have been exposed to sexual harassment and assault during deployment may benefit from integrated trauma-focused treatments and treatments focused on decreasing SUD symptoms.

Context Matters for the Socially Anxious: Moderating Role of Drinking Context on Alcohol Outcome Expectancies.

Background: Moderating effects of alcohol outcome expectancies (AOE) on the social anxiety (SA)-alcohol misuse relationship are mixed. This may be explained by differential relationships between SA and context-specific AOE. Gender may further moderate these associations, as it influences SA, AOE, and drinking behaviors. Objectives: To examine the moderating role of drinking context (i.e. convivial, negative coping, or personal-intimate) and gender on the relationships between SA and three AOE (i.e. tension reduction, sociability, and sexuality). Methods: Participants (n = 436, Mage=19.32, 72% female, 85.8% White) were 218 undergraduates with elevated SA (high SA group) and a gender-matched low SA group (n = 218) drawn from a larger undergraduate sample (N = 1,015). Participants completed three versions of an AOE measure, differing by drinking context considered. Results: A significant SA group x context x gender interaction was found for tension reduction AOE; compared to men, women in the low SA group reported greater tension reduction AOE in negative coping contexts. Significant SA group and context main effects suggest that sociability and sexuality AOE are endorsed more in the high (vs. low) SA group, and in convivial and personal-intimate compared to negative coping contexts. Conclusions/Importance: Tension reduction AOE vary depending on the drinking context, SA, and gender. Assessment of AOE in specific drinking contexts may help to identify which individuals may be at greatest risk for alcohol misuse and help inform treatment of SA-related problem drinking.