Skip to main content
Log in

Cognitive Distortions in the Dual Diagnosis of PTSD and Substance Use Disorder

  • Published:
Cognitive Therapy and Research Aims and scope Submit manuscript

Abstract

This study evaluated cognitive distortions in a dual diagnosis sample (102 women with PTSD and substance use disorder) compared to a single diagnosis sample (27 women with PTSD alone). Three questions are addressed: (1) psychometric properties of a new measure, the Cognitive Distortions Scale (L. M. Najavits, 1993); (2) prevalence and type of cognitive distortions; and (3) specificity of cognitive distortions. Results suggest that the psychometric properties of the new scale appear promising, the dual diagnosis sample reported higher levels of cognitive distortion than the single diagnosis sample, and there appears to be specificity for dual diagnosis distortions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  • American Psychiatric Association. (1994). American Psychiatric Association: Diagnostic and statistical manual of mental disorders-IV. Washington, DC: Author.

    Google Scholar 

  • Back, S. E., Dansky, B. S., Carroll, K. M., Foa, E. B., & Brady, K. T. (2001). Exposure therapy in the treatment of PTSD among cocaine-dependent individuals: Description of procedures. Journal of Substance Abuse Treatment, 21, 35-45.

    Google Scholar 

  • Barriga, A., Landau, J., Stinson, B., Liau, A., & Gibbs, J. (2000). Cognitive distortion and problem behaviors in adolescents. Criminal Justice and Behavior, 27(1), 36-56.

    Google Scholar 

  • Beck, A. T., Wright, F. D., Newman, C. F., & Liese, B. S. (1993). Cognitive Therapy of Substance Abuse. New York: Guilford.

    Google Scholar 

  • Brady, K. T., Killeen, T., Saladin, M. E., Dansky, B., & Becker, S. (1994). Comorbid substance abuse and posttraumatic stress disorder: Characteristics of women in treatment. American Journal on Addictions, 3, 160-164.

    Google Scholar 

  • Briere, J. (2001). Cognitive Distortions Scale. Los Angeles: Psychological Assessment Resources.

    Google Scholar 

  • Briere, J., Runtz, M., Giancola, P., Mezzich, A., Clark, D., & Tarter, R. (1993). Cognitive distortions, aggressive behavior, and drug use in adolescent boys with and without a family history of a substance use disorder. Journal of Interpersonal Violence, 8 (3), 312-330.

    Google Scholar 

  • Brown, P. J., Recupero, P. R., & Stout, R. (1995). PTSD substance abuse comorbidity and treatment utilization. Addictive Behaviors, 20, 251-254.

    Google Scholar 

  • Burns, D. (1980). Feeling good: The new mood therapy. New York: William Morrow.

    Google Scholar 

  • Cottler, L. B., Compton, W. M., Mager, D., Spitznagel, E. L., & Janca, A. (1992). Posttraumatic stress disorders among substance users from the general population. American Journal of Psychiatry, 149, 664-670.

    Google Scholar 

  • Crocker, L., & Algina, J. (1986). Introduction to classical and modern test theory. New York: CBS College.

    Google Scholar 

  • Dansky B. S., Saladin, M., Brady, K., Kilpatrick, D. G., & Resnick, H. S. (1995). Prevalence of victimization and posttraumatic stress disorder among women with substance use disorders: A comparison of telephone and in-person assessment samples. International Journal on the Addictions, 30, 1079-1099.

    Google Scholar 

  • Earley, P. H. (1991). The cocaine recovery book. Newbury Park, CA: Sage.

    Google Scholar 

  • Evans, K., & Sullivan, J. M. (1995). Treating addicted survivors of trauma. New York: Guilford.

    Google Scholar 

  • First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1994). Structured Clinical Interview for Axis I DSM-IV Disorders-Patient edition (SCID-I/P, Version 2.0). New York: New York State Psychiatric Institute, Biometrics Research Department.

    Google Scholar 

  • Green, B. (1996). Trauma history questionnaire: Adapted from the DSM-IV field trial high magnitude stressor questionnaire. In B. H. Stamm & E. M. Varra (Eds.), Measurement of stress, trauma, and adaptation (pp. 366-368). Lutherville, MD: Sidron.

    Google Scholar 

  • Grice, D. E., Brady, K. T., Dustan, L. R., Malcolm, R., & Kilpatrick, D. G. (1995). Sexual and physical assault history and posttraumatic stress disorder in substance-dependent individuals. American Journal on Addictions, 4, 297-305.

    Google Scholar 

  • Kempton, T., Van Hasselt, V., Bukstein, O., & Null, J. (1994). Cognitive distortions and psychiatric diagnosis in dually diagnosed adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 33 (2), 217-222.

    Google Scholar 

  • Kofoed, L., Friedman, M. J., & Peck, R. (1993). Alcoholism and drug abuse in inpatients with PTSD. Psychiatric Quarterly, 64, 151-171.

    Google Scholar 

  • Kranzler, H. R., Kadden, R. M., Babor, T. F., Tenner, H., Rounsaville, B. J. (1996). Validity of the SCID in substance abuse patients. Addiction, 91, 859-868.

    Google Scholar 

  • McKay, M., Davis, M., & Fanning, P. (1981). Thoughts and feelings: The art of cognitive stress intervention. Oakland, CA: New Harbinger.

    Google Scholar 

  • McLellan, A. T., Kushner, H., Metzger, D., Peters, R., Smith, I., Grissom, G. (1992). The fifth edition of the Addiction Severity Index. Journal of Substance Abuse Treatment, 9, 199-213.

    Google Scholar 

  • McLellan, A. T., Luborsky, L., Cacciola, J., Griffith, J., & Evans, F. (1985). New data from the Addiction Severity Index: Reliability and validity in three centers. Journal of Nervous and Mental Disease, 173, 412-423.

    Google Scholar 

  • Najavits, L. M. (1993). Cognitive Distortions Scale. Unpublished measure. Harvard Medical School/McLean Hospital, Boston, MA.

    Google Scholar 

  • Najavits, L. M. (2002a). Seeking Safety: A new psychotherapy for posttraumatic stress disorder and substance use disorder. In Ouimette, P., Brown, P. J. (Eds.), Trauma and substance abuse: Causes, consequences, and treatment of comorbid disorders. Washington, DC: American Psychological Association Press, 2002: 147-170.

    Google Scholar 

  • Najavits, L. M. (2002b). Seeking Safety: A treatment manual for PTSD and substance abuse. New York: Guilford.

    Google Scholar 

  • Najavits, L. M., Gastfriend, D. R., Barber, J. P., Reif, S., Muenz, L. R., Blaine, J., et al. (1998). Cocaine dependence with and without posttraumatic stress disorder among subjects in the NIDA Collaborative Cocaine Treatment Study. American Journal of Psychiatry, 155, 214-219.

    Google Scholar 

  • Najavits, L. M., Weiss, R. D., & Shaw, S. R. (1997). The link between substance abuse and posttraumatic stress disorder in women: A research review. The American Journal on Addictions, 6, 273-283.

    Google Scholar 

  • Najavits, L. M., Weiss, R. D., & Shaw, S. R. (1999). A clinical profile of women with PTSD and substance dependence. Psychology of Addictive Behaviors, 13, 98-104.

    Google Scholar 

  • Najavits, L. M., Weiss, R. D., Shaw, S. R., & Muenz, L. R. (1998). “Seeking Safety”: Outcome of a new cognitive-behavioral psychotherapy for women with posttraumatic stress disorder and substance dependence. Journal of Traumatic Stress, 11, 437-456.

    Google Scholar 

  • Ouimette, P. C., Brown, P. J., & Najavits, L. M. (1998). Course and treatment of patients with both substance use and posttraumatic stress disorders. Psychology of Addictive Behaviors, 23, 785-795.

    Google Scholar 

  • Ouimette, P. C., Finney, J. W., & Moos, R. H. (1999). Two-year posttreatment functioning and coping of substance abuse patients with posttraumatic stress disorder. Psychology of Addictive Behaviors, 13, 105-114.

    Google Scholar 

  • Randall, C., Thomas, S., & Thevos, A. (2001). Concurrent alcoholism and social anxiety disorder: A first step toward developing effective treatments. Alcoholism: Clinical and Experimental Research, 25(2), 210-220.

    Google Scholar 

  • Toneatto, T. (1999). Cognitive psychopathology of problem gambling. Substance Use and Misuse, 34(11), 1593-1604.

    Google Scholar 

  • Triffleman, E., Carroll, K., & Kellogg, S. (1999). Substance dependence posttraumatic stress disorder therapy: An integrated cognitive-behavioral approach. Journal of Substance Abuse Treatment, 17, 3-14.

    Google Scholar 

  • Trotter, C. (1992). Double bind. Minneapolis: Hazelden.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lisa M. Najavits.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Najavits, L.M., Gotthardt, S., Weiss, R.D. et al. Cognitive Distortions in the Dual Diagnosis of PTSD and Substance Use Disorder. Cognitive Therapy and Research 28, 159–172 (2004). https://doi.org/10.1023/B:COTR.0000021537.18501.66

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/B:COTR.0000021537.18501.66

Navigation