Cocaine dependence and PTSD: a pilot study of symptom interplay and treatment preferences.

Cocaine dependence and posttraumatic stress disorder (PTSD) frequently co-occur. Little is known, however, about patients' perceptions of symptom connectedness and preferences for treatment. This pilot study preliminarily investigated perceptions of symptom interplay and preferences regarding concurrent or sequential models of psychotherapy, therapy format, and treatment modalities. Participants were 23 individuals with current cocaine dependence and PTSD. The majority (95.5%) reported a functional relationship between cocaine use and PTSD symptoms (p<0.001). Improvement in PTSD symptoms was typically (63.6%) associated with a decrease in cocaine use (p<0.01). Similarly, a worsening of PTSD symptoms was typically (86.4%) associated with an increase in cocaine use (p<0.001). In contrast, improvement/deterioration in cocaine use was not significantly related to subsequent improvement/deterioration in PTSD symptoms. This finding suggests that changes in PTSD may be an important risk factor to consider among individuals with cocaine dependence and PTSD. Approximately 41% preferred a concurrent model of therapy in which the cocaine use and PTSD are treated simultaneously in therapy. The findings highlight the functional relationship between these two disorders and have direct implications for treatment interventions.