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Untested conventional wisdom has held that exposure for post-traumatic stress disorder (PTSD) could increase substance use in adolescents with “substance use problems” (SUPs) as self-treatment for increased stress caused by traumatic reminders. To test this assumption, investigators randomized 124 adolescents (mean age, 15; 87% female) with comorbid SUPs and interpersonal-violence–associated PTSD to risk reduction through family therapy (RRFT), a manual-based therapy for such comorbidity, or to treatment as usual (TAU).
SUP was defined as use ≥1 day in the past 3 months of alcohol, marijuana, or other nonnicotine drugs (e.g., cocaine, stimulants, or hallucinogens). RRFT addressed self-regulation deficits, sexual decision making, and risk red…