Short Course of PTSD Therapy Found to Help Vets

Post-traumatic stress disorder (PTSD) is often a debilitating condition requiring several months of treatment, leaving those affected unable to work or care for their families. A new study, however, suggests that many in the military who suffer from PTSD can benefit from an expedited course of treatment.

In the first study of its kind, researchers found that Prolonged Exposure (PE) therapy was as effective when administered over two weeks as when it is provided over eight weeks for active-duty military personnel.

The findings from researchers at Penn Medicine, under the leadership of Edna B. Foa, Ph.D., the University of Texas Health Science Center at San Antonio, and the STRONG STAR Consortium appear in JAMA.

The research team believes that the results obtained among active military personnel also offer possible new treatment options for veterans and civilians.

Experts explain that as many as 10 to 20 percent of military members deployed to Iraq and Afghanistan following the September 11th attacks suffer from PTSD.

A constant increase in the number of individuals suffering from PTSD as a result of massive natural disasters, terror attacks, and the wars in Iraq and Afghanistan, has prompted an urgent need for effective and efficient evidence-based treatments for PTSD.

“This study not only addresses the pressing need for an effective treatment option for PTSD but also encourages a more speedy treatment and recovery, allowing affected service members to return to active duty sooner and enabling veterans to reintegrate into civilian life more quickly,” said Foa.

“Our findings are good news — about half of those treated achieved remission and many others demonstrated substantial relief from their symptoms. This is critical for the hundreds of thousands of post-9/11 combat veterans affected by PTSD and can do so much to improve lives and assist with military readiness.”

The study was conducted at Fort Hood in collaboration with Carl R. Darnall Army Medical Center and was co-led by Alan Peterson, Ph.D., a professor of psychiatry at UT Health San Antonio and director of the STRONG STAR Consortium. It is the largest and first-ever randomized clinical study of PE for PTSD with active-duty military members.

PE is a form of cognitive-behavioral therapy that involves exposure to trauma memories and daily life trauma reminders. Previous studies have proven PE is quite effective for treating civilians and veterans with PTSD.

In this five-year (2011-2016) study, the researchers sought to determine whether PE could have similar success with active-duty military personnel. The researchers examined the benefit of various methods for delivering PE.

Options include:

  • Massed-PE, (10 therapy sessions administered over two weeks) and Spaced-PE (10 sessions administered over eight weeks);
  • Present Centered Therapy (PCT), a non-trauma-focused therapy that involves identifying and discussing daily stressors in 10 sessions over eight weeks;
  • And Minimal Contact Control (MCC), which included supportive phone calls from therapists once weekly for four weeks.

Of the 370 military personnel with PTSD who participated in the single-blind randomized clinical trial, 110 received Massed-PE, 110 received Spaced-PE, 110 received PCT, and 40 received MCC.

Outcomes were assessed before treatment, at two weeks and 12-weeks after treatment, and at six month follow up. Patients who received Massed-PE therapy, delivered over two weeks, saw a greater reduction in PTSD symptoms than those who received MCC.

Importantly, Massed-PE therapy was found to be equally effective to Spaced-PE in reducing PTSD symptom severity. The researchers also found that PCT might be an effective treatment option for PTSD in active military personnel although it was less effective than PE in veteran and civilian PTSD sufferers.

While all participants in the study saw some reduction in PTSD symptoms, the researchers say these symptom reductions were relatively modest, indicating there is still more work to be done with treating active military personnel with PTSD.

“This seminal study validates that combat-related PTSD can be effectively treated in active duty military personnel, and it sets a high benchmark to which future studies will be compared. However, we need to do more,” said Peterson, a retired lieutenant colonel and clinical psychologist with the U.S. Air Force.

“Even with our most effective PTSD treatments, we’re seeing greater challenges to successful recovery from combat-related PTSD.”

The researchers plan to expand their work with the Department of Defense by conducting additional studies: to determine the best methods for training military mental health providers to deliver PE therapy, and; by further tailoring PE treatments to better meet the unique obstacles to successful treatment for combat PTSD.

Source: Penn Medicine/EurekAlert

Posted by Patricia Adams