“…Whereas some research studies have documented worse substance use outcomes for substance-dependent adults with comorbid PTSD (e.g., Brown, Stout, & Mueller, 1996), other studies have not replicated these findings (e.g., Ouimette, Brown, & Najavits, 1998). A separate area of research has suggested that health problems may enhance motivation for changing addictive behaviors (e.g., Kristenson, 1987;Monti et al, 1999;O'Toole, Pollini, Ford, & Bigelow, 2006;Smith, Hodgson, Bridgeman, & Shepherd, 2003;Tate et al, 2005). Possibly, the increased health problems experienced by those with trauma exposure and PTSD enhanced their motivation for maintaining abstinence from alcohol and drug use after treatment.…”