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Suppose Mr. Brooks, your new patient with very clear PTSD, also drinks a lot of alcohol. Which will help him more—targeting his alcohol use with a well-researched treatment, such as relapse prevention therapy, or targeting his PTSD with an exposure-based treatment? Will his alcohol use interfere with his ability to do exposure work? Does it make any difference what version of PTSD he has? Remember the 4 clusters of symptoms—intrusive thoughts and memories, avoidance, negative cognition, and mood and physiologic arousal. Would any 1 of these clusters affect how you target his treatment, alcohol first or PTSD first?
Hi! Jim Phelps here for the Psychopharmacology Institute. Let’s jump to one answer based on a recent study by Herry Patel and colleagues. Based on prior studies plus their own, it doesn’t appear that any of the symptom clusters clearly drives treatment. For example, you might have thought, as Dr. Patel and
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