Table 2 Descriptive results per vignette scored by clinicians (n = 31) on the indication of integrated treatment of SUD and PTSD
Vignette | min | max | mean (SD) | % ≤ − 3 no integrated treatment | % ≥ + 3 integrated treatment | % ≥ + 3 after filter non- choosers (n) |
|---|---|---|---|---|---|---|
1. Female, 45, cocaine, heroin, cannabis. Multiple traumatic events (sexual abuse, rape and violence) and prostitution. Complex PTSD and BPD with antisocial tendencies. Many social and contextual problems. | −4 | 5 | 3.2 (2.0) | 3.2 | 71.1 | 73.3 (30) |
2. Male, 33, alcohol and cannabis. Abused for many years by male babysitter. PTSD and BPD, followed DGT. Has residence and a job. In debt, has a limited social network | −3 | 5 | 2.8 (2.3) | 3.2 | 64.6 | 69.0 (29) |
3. Male, 23, excessive amounts of alcohol each weekend leading to amnesia after seeing his friend fall to his death. Re-experiences the accident, feels guilty. Lives with his girlfriend, has a job. | −4 | 5 | 3.3 (2.5) | 6.4 | 77.4 | 82.8 (29) |
4. Male, 59, alcohol, many clinical therapies. Periods of sobriety. PTSD, physical and sexual abuse, intellectual disability. On sick leave, drinks after half past five. Suicidal tendencies 3 weeks ago. Girlfriend, acquaintances drink. | 0 | 5 | 3.8 (1.4) | 0.0 | 77.5 | 80.0 (30) |
5. Female, 25, cannabis, alcohol and GHB. Personality disorder NOS, PTSD. Stepfather was violent and stepbrother was sexually inappropriate. Removed from home at young age. Many different institutions and addresses. Several suicide attempts, now anxiety, depression and trouble controlling emotions. | 0 | 5 | 3.8 (1.7) | 0.0 | 77.5 | 85.7 (28) |
6. Female 55, social drinker until an armed robbery. Since then 2 bottles of wine a day to lower anxiety and tension caused by the trauma. Married, two daughters, works, exercises and makes music. | −3 | 5 | 3.6 (2.0) | 3.3 | 74.3 | 82.1 (28) |
7. Female, 61, alcohol and PTSD. Has a daughter from her father who abused her and gave her alcohol. Daughter given up for adoption contacted patient 5 years ago and alcohol consumption further increased. Partner and 2 adult children. | 0 | 5 | 3.1 (1.6) | 0.0 | 71.0 | 81.5 (27) |
8. Female, 32, cannabis, abstinent for 5 months after treatment, chronic PTSD. Labelled ‘untreatable’ during childhood. Despondency and negative self-image. No work, friend abuse drugs. | −5 | 5 | 0.7 (3.5) | 29.0 | 38.7 | 44.4 (27) |
9. Female, 20, cannabis and cocaine, many traumatic experiences. Symptoms consistent with PTSD and indications found for impaired personality development, probably Clusters B (problems with regulation of emotions, fragile self-image). No permanent address, no income. | −4 | 5 | 3.0 (2.5) | 6.4 | 74.2 | 82.1 (28) |
10. Female, 30, Turkish, cannabis dependency in remission after treatment. PTSD and depression. Lives with sister, no social network. Suicidal in the past. | −4 | 5 | 1.1 (3.1) | 16.2 | 35.5 | 39.3 (28) |
11. Female, 31, GHB, complex PTSD and psychotic disorder NOS. Exhibits borderline personality traits during long-term GHB use. Hospitalized several times for GHB detox. Has her own home. Parents are supportive, are her children’s guardians. Partner is supportive, but also uses GHB. | −4 | 5 | 2.7 (2.4) | 3.2 | 61.4 | 76.0 (25) |
12. Male, 20, Moroccan, alcohol, depressive symptoms, PTSD, latent suicidality and borderline intellectual functioning. Homosexual orientation which his culture does not accept and parents do not know about. Physically abused by a group because of his sexuality. Lives with residential guidance, dept., no daytime activities. | −4 | 5 | 2.9 (2.0) | 3.2 | 67.7 | 75.0 (28) |
13. Female, 52, alcohol and amphetamine, PTSD, psychotic disorder NOS and cognitive disorders due to physical disorder. Is abstinent. Lives independently with guidance, works on a care farm. | −4 | 5 | 2.3 (2.4) | 6.4 | 58.0 | 66.7 (27) |
14. Female, 66, alcohol use halved with Campral. Drinks since her ‘coming-out’ as a lesbian. Happy with her life. Suffers form anxiety and avoidance after a car accident 10 years ago. Lives with partner, on sick leave from her job. Fairly extensive social network. | −5 | 5 | 2.1 (2.9) | 9.6 | 58.1 | 62.1 (29) |
15. Male, 20, alcohol and cannabis. History of amphetamine dependency. ADHD, stagnated emotional development and PTSD. Mandatory contact with addiction care because of joyriding under the influence. Insecure attachment in his upbringing and bullying, fundamentally insecure. Lives in a sheltered housing project, has a partner. | −3 | 5 | 3.3 (1.8) | 3.2 | 74.2 | 79.3 (29) |