{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T13:10:15Z","timestamp":1765113015203,"version":"3.37.3"},"reference-count":45,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T00:00:00Z","timestamp":1714348800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Addict"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and objectives<\/jats:title><jats:p>The provider\u2013patient relationship is integral to medical practice and health outcomes, particularly among vulnerable patient populations. This study compared the provider\u2013patient relationship among pregnant patients with opioid\u2010use disorder (OUD), who did or did not have a history of moderate to severe trauma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was an exploratory data analysis of 119 patients enrolled in the Support Models for Addiction Related Treatment trial. Probable posttraumatic stress disorder (PTSD) was determined by a score\u2009\u2265\u200931 on the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. The provider\u2013patient relationship was assessed at 26\u2009\u00b1\u20094 weeks of pregnancy using the Kim Alliance Scale (KAS). Multivariable regression was used to examine the association of KAS with probable PTSD among pregnant people with OUD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean KAS score for pregnant participants without probable PTSD (<jats:italic>N<\/jats:italic>\u2009=\u200988) was 61.4 (SD\u2009\u00b1\u20092.8) and for pregnant participants with probable PTSD (<jats:italic>N<\/jats:italic>\u2009=\u200931) was 59.6 (SD\u2009\u00b1\u20093.7). Results demonstrated significant differences in KAS scores between those with and without probable PTSD after adjusting for demographic variables. Adjusted mean total KAS scores and scores on Empowerment and Communication subscales were significantly lower among those with probable PTSD compared to those without (<jats:italic>p<\/jats:italic>\u2009=\u2009.04 and 0.02, respectively) but did not differ significantly on Collaboration and Integration subscales.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and scientific significance<\/jats:title><jats:p>Analyses show an association between probable PTSD and provider\u2013patient relationship among pregnant patients with OUD, with those with probable PTSD having a worse alliance with obstetric providers. This novel finding helps characterize the provider\u2013patient relationship among a uniquely vulnerable population and can inform efforts to integrate trauma\u2010informed practices into prenatal care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajad.13570","type":"journal-article","created":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T06:19:47Z","timestamp":1714457987000},"page":"569-575","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Provider\u2013patient relationships and trauma among pregnant patients with opioid\u2010use disorder"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9114-0521","authenticated-orcid":false,"given":"Molly","family":"Doernberg","sequence":"first","affiliation":[{"name":"Yale School of Medicine New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Gilstad\u2010Hayden","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Yale School of Medicine New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly A.","family":"Yonkers","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Massachusetts Chan Medical School Worcester Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariadna","family":"Forray","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Yale School of Medicine New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,4,29]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(23)00454-0"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000472"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2017.07.023"},{"issue":"3","key":"e_1_2_7_5_1","article-title":"US trends in drug overdose mortality among pregnant and postpartum persons, 2017\u20102020","volume":"43","author":"Bruzelius E","year":"2023","journal-title":"Obstet Anesth Dig"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000005115"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-024-03019-w"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.02.011"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2019.4791"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2020.1870"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.24991"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2016.10.009"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-022-04797-7"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-016-2073-2"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_272_17"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2007.01.003"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200101000-00004"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.12349"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2014.558"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.842410"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1037\/h0085885"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/0283430310000528"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1370\/afm.757"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1370\/afm.267"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2006.09.013"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/21501319221082352"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.93.10.1713"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2013.02.018"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcop.20351"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.abrep.2021.100372"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0261751"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_7_34_1","unstructured":"WeathersF LitzB KeaneT PalmieriP MarxB SchnurrP. 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