The effect of posttraumatic stress disorder on risk-taking propensity among crack/cocaine users in residential substance abuse treatment

Background: The co-occurrence of posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) has been found to be associated with a range of negative clinical outcomes (e.g., relapse, suicide, legal problems, HIV infection). However, less is known about the particular factors that may be placing individuals with a co-occurring PTSD and SUD diagnosis at risk for these outcomes. The construct of risk-taking propensity may hold particular promise. Methods: To investigate the relevance of risk-taking propensity to PTSD-SUD patients, differences in risk-taking propensity were examined among 90 crack/cocaine dependent patients in residential substance abuse treatment with (n = 20) or without (n = 70) a current PTSD diagnosis. Risk-taking propensity was assessed using an established behaviorally based measure, the Balloon Analogue Risk Task (BART). Results: Crack/cocaine dependent patients with PTSD exhibited significantly greater levels of risk-taking propensity than patients without PTSD, and this difference remained significant even when controlling for the presence of comorbid psychiatric disorders and current psychotropic medication use. No evidence was found for a different pattern of change in risktaking propensity from the beginning to the end of the task as a function of PTSD status. Conclusions: Although preliminary, results suggest the need to further investigate risk-taking propensity as a factor that may be associated with the negative clinical outcomes observed among crack/cocaine users with PTSD.