The current proposal is a request for a K21 Scientist Development Award. The candidate, Dr. Bonnie Dansky, is a young scientist/practitioner/teacher in the field of victimization/PTSD at the National Crime Victims Research and Treatment Center (NCVC), and a K21 Scientist Development Award would enable her to gain expertise in the interface of crime-related PTSD (CR-PTSD) and substance use disorders. It is expected that Dr. Dansky will learn about the clinical and didactic aspects of substance use disorders and how to conduct scientifically sound and meaningful research in the substance use area. While carrying out the proposed research plan, the candidate will gain knowledge and skills concerning patterns of substance use; physiological features of withdrawal from alcohol, cocaine, and other substances; psychological and pharmacological treatment approaches to substance abuse and dependence; assessment of severity of substance use disorders; and methods of testing for substance relapse (i.e. urine drug screen and breathalyzer). The research plan outlined below is a systematic examination of the assessment of PTSD symptomatology during the course of cocaine withdrawal. Clearly one of the fist issues which must be addressed in any exploration of comorbidity is the accuracy of assessment and symptom overlap with acute intoxication and withdrawal states. It has been estimated that 40% of individuals in treatment for a substance use disorder suffer from current PTSD, and the substantial symptom overlap between CR-PTSD and drug/alcohol intoxication and withdrawal can make a diagnosis of CR-PTSD in the face of active substance use or during acute withdrawal states particularly difficult. The central focus of the proposed research plan is to assess symptoms of PTSD during withdrawal and early abstinence in a group of individuals with cocaine dependence who also have been traumatized. Cocaine dependent individuals were targeted due to the particularly high prevalence rates of victimization and PTSD noted in this population (Cottler et al., 1992; Sturgis et al., 1992). All patients entering the Center for Drug and Alcohol Programs (CDAP) inpatient program, who meet criteria for cocaine dependence and have used cocaine within 24 hours prior to admission, will be screened at approximately 48 hours following their last cocaine use for trauma history and PTSD. Those who are positive for a PTSD Criterion A event will be eligible for further participation in the project, which entails 5 additional assessments of symptoms of cocaine withdrawal and PTSD at 5, 10, 14, 21, and 28 days post-use. The principal area to be investigated is the extent to which symptoms of CR-PTSD change in individuals with cocaine dependence during the detoxification/withdrawal process. A K21 Scientist Development Award would not only afford Dr. Dansky an opportunity to expand and develop her skills as a researcher but would also provide the NCVC and CDAP with a psychologist who is an expert in the area of comorbid PTSD and substance use disorders.
|Coffey, Scott F; Schumacher, Julie A; Brady, Kathleen T et al. (2007) Changes in PTSD symptomatology during acute and protracted alcohol and cocaine abstinence. Drug Alcohol Depend 87:241-8|
|Coffey, S F; Dansky, B S; Carrigan, M H et al. (2000) Acute and protracted cocaine abstinence in an outpatient population: a prospective study of mood, sleep and withdrawal symptoms. Drug Alcohol Depend 59:277-86|