This study adds important information to the existing literature on TE, PTSD, and SUDs, by showing that while the risk for alcohol and nicotine dependence is elevated among adults who have PTSD symptoms after experiencing trauma, TE itself also increases the risk for these disorders. This issue requires further investigation for marijuana dependence, since findings suggested similar relationships, but sample size may have limited the ability to find significance. Clinically, these results indicate the need for vigilance regarding comorbidity in multiple types of treatment settings, including PTSD and substance disorder treatment centers, as well as the need to provide integrated treatment for both conditions. Treatment providers should also be aware that trauma-exposed individuals without PTSD have elevated alcohol and nicotine dependence rates, and thus could potentially benefit from screening and possible interventions. Furthermore, PTSD symptoms, rather than diagnoses, provided more information about increased risk for dependence, thus, providers could target treatments to particular symptoms to more effectively treat both disorders. If coping or affect regulation are motives for substance dependence among trauma-exposed patients, therapists could help patients identify and utilize
