{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T01:49:44Z","timestamp":1790214584532,"version":"4.1.0"},"reference-count":65,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T00:00:00Z","timestamp":1681084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["K23NR020208"],"award-info":[{"award-number":["K23NR020208"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Problem statement<\/jats:title>\n                    <jats:p>Seeking Safety (SS) is a widely implemented cognitive\u2010behavioral therapy for comorbid post\u2010traumatic stress disorder (PTSD) and substance use disorder (SUD). It is a present\u2010focused coping skills model that is highly flexible, with varied methods of delivery, to maximize acceptability and client access. The purpose of this meta\u2010analysis is to examine the effect of SS on comorbid PTSD and SUD across randomized control trials (RCTs). In addition, ours is the first meta\u2010analysis to examine the dose\u2010response of SS by comparing delivery of all 25 SS topics versus fewer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and design<\/jats:title>\n                    <jats:p>\n                      Articles published before January 2, 2023 (CINAHL\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a016, PsycINFO\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a031, MEDLINE\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a027, Cochrane\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a038, and Scopus\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0618) were searched. Seven studies were included for meta\u2010analysis and dose\u2010response analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Based on effect sizes (ES), meta\u2010analysis revealed that SS has a medium group, time (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.04), and time by group effect on substance use per the Addiction Severity Index at 3 months and a small effect on Clinician\u2010Administered PTSD Scale scores by group, a large effect by time, and a medium time by group (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.002) effect at 6 months. Based on the pooled ES examining various measures across multiple timepoints, SS had small to medium effects on substance use by time, group, or time by group and medium to large effects on PTSD symptoms by time, group, or time by group (except for the group effect at 3\u2010month follow\u2010up). Significant effects were found for substance use by time at 3 and 6 months and for PTSD postintervention, at 6 months and 9 months by group, time, and time by group while only by time at 3 months. Meta\u2010regression revealed that partial dose versions of SS generally function as well as the full dose version of SS when observing long\u2010term effects (greater than 3 months).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Findings suggest SS has merit in treating PTSD symptoms and SUD. Based on the summarized effect sizes, SS appears more effective in reducing PTSD than substance use, which converges with the larger treatment outcome literature that consistently finds this. We explore reasons that treatment of SUD is more challenging than treating PTSD and offer suggestions for practitioners. We emphasize the need for future studies to utilize common measures and provide full details of treatment delivery for optimal comparison across studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.2999","type":"journal-article","created":{"date-parts":[[2023,4,11]],"date-time":"2023-04-11T00:40:02Z","timestamp":1681173602000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Seeking safety intervention for comorbid post\u2010traumatic stress and substance use disorder: A meta\u2010analysis"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3652-1196","authenticated-orcid":false,"given":"Athena D. 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Lewis College of Nursing and Health Professions Georgia State University  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9328-2315","authenticated-orcid":false,"given":"Wenhui","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Nell Hodgson Woodruff School of Nursing Emory University  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Febres\u2010Cordero","sequence":"additional","affiliation":[{"name":"The Nell Hodgson Woodruff School of Nursing Emory University  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen D.","family":"Clark","sequence":"additional","affiliation":[{"name":"School of Nursing University of California San Francisco  San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith","family":"Klepper","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Nursing Johns Hopkins University  Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercy","family":"Coleman","sequence":"additional","affiliation":[{"name":"Byrdine F. Lewis College of Nursing and Health Professions Georgia State University  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ursula","family":"Kelly","sequence":"additional","affiliation":[{"name":"The Nell Hodgson Woodruff School of Nursing Emory University  Atlanta Georgia"},{"name":"Atlanta VA Health Care System  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,4,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0036869"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/16506073.2018.1522371"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2018.11.032"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","unstructured":"Basu A.(2017).How to conduct meta\u2010analysis: A Basic tutorial. 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