Results from a pilot study investigating Behavioral Activation for veterans with co-occurring Posttraumatic Stress Disorder (PTSD) and Alcohol Use Disorder (AUD) were posted on ClinicalTrials.gov on 2026-04-28. The study enrolled 10 participants to compare an adaptation of Behavioral Activation to Relapse Prevention treatment.
Background
Posttraumatic Stress Disorder (PTSD) and Alcohol Use Disorder (AUD) frequently co-occur, particularly among U.S. military veterans, presenting complex challenges for treatment. The presence of both conditions can exacerbate symptoms, complicate recovery, and impact overall quality of life. Effective interventions often need to address both disorders concurrently, requiring adapted approaches to behavioral therapies. Behavioral Activation (BA) is a psychotherapy that aims to increase engagement in positive activities, while Relapse Prevention (RP) focuses on identifying and preventing high-risk situations for substance use. Exploring and adapting these behavioral interventions for the specific needs of veterans with co-occurring PTSD and AUD is crucial for improving treatment outcomes.
Trial design
This completed study, identified as Phase NA, enrolled 10 U.S. military veterans with co-occurring Alcohol Use Disorder and Posttraumatic Stress Disorder. The trial's primary aims were to adapt Behavioral Activation for this specific population, evaluate its feasibility, acceptability, and preliminary effects, and explore geospatial analysis as a new method for measuring AUD/PTSD recovery. The study compared the adapted Behavioral Activation (BA) intervention to Relapse Prevention (RP) treatment, both being behavioral interventions.
Key results
The study collected multiple measurements for alcohol use, PTSD severity, and psychosocial functioning at different time points for both treatment arms. For 'Timeline Follow-Back (Alcohol Use)', the Behavioral Activation (BA) group showed mean values of 4.36 (Standard Deviation 1.59) and subsequently 1.82 (Standard Deviation 0.00) drinks per day. The Relapse Prevention (RP) group showed mean values of 3.90 (Standard Deviation 0.85) and then 3.31 (Standard Deviation 2.70) drinks per day.
For 'Clinician-Administered PTSD Scale for DSM-5 (PTSD Severity)', the BA group had mean scores of 36.60 (Standard Deviation 9.37) and later 15.67 (Standard Deviation 10.60) symptom severity. The RP group had mean scores of 38.20 (Standard Deviation 10.64) and then 20.00 (Standard Deviation 14.00) symptom severity.
Regarding 'Brief Inventory of Psychosocial Functioning (Psychosocial Functioning)', the BA group reported mean impairment percentages of 70.95 (Standard Deviation 15.74) and subsequently 26.19 (Standard Deviation 28.87). The RP group reported mean impairment percentages of 50.74 (Standard Deviation 18.49) and then 29.37 (Standard Deviation 9.91).
Mixed Models Analysis was used to test the statistical significance of the time-by-arm interaction effect, assessing whether changes in outcomes from baseline to post-treatment differed between the treatment arms. The F values for these analyses ranged from 0.19 to 5.45, with corresponding p-values from 0.6728 to 0.0801. The lowest p-value observed was 0.0801, indicating no statistically significant difference in changes between the treatment arms for the measured outcomes.
What this means
The posted results from this pilot study, with an enrollment of 10 veterans, provide preliminary data on adapting and evaluating Behavioral Activation for co-occurring PTSD and AUD. While the study's primary aims included assessing feasibility and preliminary effects, the key analyses did not show a statistically significant difference in changes in alcohol use, PTSD severity, or psychosocial functioning between the Behavioral Activation and Relapse Prevention groups. The lowest p-value of 0.0801 suggests that any observed differences in improvement between the two behavioral interventions were not statistically significant in this small sample. These findings can inform the design of larger, adequately powered studies to further investigate the efficacy of adapted behavioral interventions for veterans with co-occurring PTSD and AUD.
Source
The information regarding these trial results was obtained from ClinicalTrials.gov, a public database of clinical studies. The results for the study NCT06249386, titled "Adapting and Piloting Behavioral Activation for Veterans With Alcohol Use Disorder and Posttraumatic Stress Disorder", were posted on 2026-04-28 on clinicaltrials.gov.