# Understanding Treatment Dropout Among Women with Posttraumatic Stress Disorder and Heavy Drinking

> **NIH NIH F32** · UNIVERSITY OF WASHINGTON · 2024 · $17,282

## Abstract

Treatment dropout is a primary challenge for individuals suffering with posttraumatic stress disorder
(PTSD) and alcohol use disorder (AUD) following trauma exposure. Treatments for PTSD+AUD are effective at
reducing symptoms, yet treatment attrition is a critical issue. Dropout rates among individuals with PTSD+AUD
are higher than for those with PTSD alone, and dropout is associated with less clinical improvement. A clearer
understanding of the factors that contribute to dropout, including those who initiate services but do not start
treatment (nonstarters) and those who start but do not complete treatment (noncompleters), will enable us
to develop strategies that improve retention and treatment outcomes for this population. Examining modifiable
and theoretically informed constructs, such as difficulty tolerating emotional distress and coping motives for
alcohol use, may improve our understanding of treatment dropout. Additionally, observer ratings of in-session
behavior, or “thin slice” ratings, is a method of measuring predictors more proximal to when dropout occurs and
has the potential to be a robust predictor of dropout. Thin slice refers to short (e.g. 30 second) video clips of
expressive behavior rated by trained observers on specified constructs or outcomes of interest. The proposed
F32 will use mixed methods to explore reasons for treatment dropout using data collected from an existing
clinical trial for women with PTSD and heavy drinking following sexual assault. Specific aims are: 1) To identify
themes related to reasons for dropout for nonstarters and noncompleters by conducting qualitative interviews
with providers of sexual assault services (N = 10), which will be used to develop the “thin slice” rating
constructs of observed participant behavior for use in Aim 2. 2) To predict dropout and related treatment
processes (N = 100) using thin slice ratings and advanced statistical methods. Treatment dropout will be
examined within each treatment condition (imaginal exposure and alcohol skills training) and between
treatment conditions to test whether certain thin slice constructs are better at predicting dropout for certain
types of treatment. We will also examine trajectories of treatment processes related to dropout: difficulty
tolerating emotions and alcohol craving. 3) To enrich and contextualize Aim 2 quantitative findings by
concurrently conducting qualitative interviews exploring treatment initiation and dropout with women enrolled in
a clinical trial for PTSD and heavy drinking following sexual assault (N = 25). The applicant will receive training
in 1) PTSD and alcohol treatment process research, 2) conducting studies predicting dropout in clinical trials,
3) skill development for collecting and analyzing qualitative and quantitative data, and 4) manuscript and grant
writing. The proposed study will make substantial contributions to our understanding of dropout, a necessary
first step to the development of strategies to increas...

## Key facts

- **NIH application ID:** 10861867
- **Project number:** 5F32AA029865-03
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Elizabeth Lehinger
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $17,282
- **Award type:** 5
- **Project period:** 2022-07-01 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10861867

## Citation

> US National Institutes of Health, RePORTER application 10861867, Understanding Treatment Dropout Among Women with Posttraumatic Stress Disorder and Heavy Drinking (5F32AA029865-03). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10861867. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*