The Effect of Trauma Cue Exposure on Cocaine Cravings among Cocaine Dependent Inpatients with and without Posttraumatic Stress Disorder: Exploring the Mediating Role of Negative Affect and Discrete Negative Emotional States

This study examined the effect of personalized trauma cue exposure (relative to neutral cue exposure) on cocaine cravings within a sample of trauma-exposed cocaine dependent patients with and without current PTSD. We also examined the extent to which negative affect (as well as the discrete negative emotional states of anxiety, anger, and shame/guilt) in response to the trauma cue accounted for these cocaine cravings. Sixty cocaine dependent patients in residential substance use treatment (50% with PTSD) were exposed to a personalized trauma and neutral script on separate days. Self-reported cocaine cravings and emotional response prior to and following each script were assessed. PTSD was associated with increased cocaine cravings following a personalized trauma (but not a neutral) script, and, for men specifically, the experience of self-conscious emotions (shame and guilt) to the trauma script mediated the relationship between PTSD and cocaine cravings following trauma script exposure. Treatment implications are discussed.