Massed prolonged exposure therapy for PTSD and alcohol use: a single case experimental study of a university student

Abstract

Post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) are common among university students in South Africa. Bantjies et al. (2023) found a PTSD prevalence of 21.0% (n=28,268), and McGowan and Kagee (2013) reported that 90% (n=1337) had experienced at least one traumatic event. There is a high comorbidity between PTSD and AUD, especially in hazardous drinkers (Peltzer & Pengpid, 2015). Despite the prevalence, research on effective trauma-focused therapies (TFTs) in low-resource settings is limited (Booysen & Kagee, 2021). This study evaluates the effectiveness of massed-prolonged exposure (MPE) therapy for comorbid PTSD and AUD among South African university students, using a Single-Case Experimental Design (SCED). The participant (n=1) underwent comprehensive assessments using CAPS-5, AUDIT, PDS-5, and PCL-5, confirming PTSD and AUD diagnoses. Regular PCL-5 assessments during the intervention showed significant symptom improvement, and post-intervention assessments indicated the participant no longer met PTSD criteria. AUDIT scores also improved from 11 (harmful/hazardous drinking) to 6. The participant found MPE therapy to be feasible, acceptable, and appropriate. This study supports the effectiveness, feasibility and acceptability of MPE therapy and highlights the importance of evidence-based interventions to improve PTSD outcomes within university settings and in low-to-middle-income countries.