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      Efficacy of Prolonged Exposure Therapy, Sertraline Hydrochloride, and Their Combination Among Combat Veterans With Posttraumatic Stress Disorder : A Randomized Clinical Trial

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          Abstract

          Meta-analyses of treatments for posttraumatic stress disorder (PTSD) suggest that trauma-focused psychotherapies produce greater benefits than antidepressant medications alone.

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          Randomized trial of prolonged exposure for posttraumatic stress disorder with and without cognitive restructuring: outcome at academic and community clinics.

          Norah C Feeny, Elna Yadin, E A Hembree … (2005)
          Female assault survivors (N=171) with chronic posttraumatic stress disorder (PTSD) were randomly assigned to prolonged exposure (PE) alone, PE plus cognitive restructuring (PE/CR), or wait-list (WL). Treatment, which consisted of 9-12 sessions, was conducted at an academic treatment center or at a community clinic for rape survivors. Evaluations were conducted before and after therapy and at 3-, 6-, and 12-month follow-ups. Both treatments reduced PTSD and depression in intent-to-treat and completer samples compared with the WL condition; social functioning improved in the completer sample. The addition of CR did not enhance treatment outcome. No site differences were found: Treatment in the hands of counselors with minimal cognitive- behavioral therapy (CBT) experience was as efficacious as that of CBT experts. Treatment gains were maintained at follow-up, although a minority of patients received additional treatment. ((c) 2005 APA, all rights reserved).
          Article 0 comments Cited 138 times – based on 0 reviews     Review now
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            Prolonged Exposure Therapy for PTSD: Therapist Guide

            Edna B. Foa, Elizabeth Hembree, Barbara Rothbaum (2007)
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              CRITICAL ANALYSIS OF THE CURRENT TREATMENT GUIDELINES FOR COMPLEX PTSD IN ADULTS.

              Ad De Jongh, Patricia Resick, Lori A Zoellner … (2016)
              According to current treatment guidelines for Complex PTSD (cPTSD), psychotherapy for adults with cPTSD should start with a "stabilization phase." This phase, focusing on teaching self-regulation strategies, was designed to ensure that an individual would be better able to tolerate trauma-focused treatment. The purpose of this paper is to critically evaluate the research underlying these treatment guidelines for cPTSD, and to specifically address the question as to whether a phase-based approach is needed. As reviewed in this paper, the research supporting the need for phase-based treatment for individuals with cPTSD is methodologically limited. Further, there is no rigorous research to support the views that: (1) a phase-based approach is necessary for positive treatment outcomes for adults with cPTSD, (2) front-line trauma-focused treatments have unacceptable risks or that adults with cPTSD do not respond to them, and (3) adults with cPTSD profit significantly more from trauma-focused treatments when preceded by a stabilization phase. The current treatment guidelines for cPTSD may therefore be too conservative, risking that patients are denied or delayed in receiving conventional evidence-based treatments from which they might profit.
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                Author and article information

                Journal
                Title: JAMA Psychiatry
                Abbreviated Title: JAMA Psychiatry
                Publisher: American Medical Association (AMA)
                ISSN (Print): 2168-622X
                Publication date (Electronic): December 05 2018
                Affiliations
                [1 ]Mental Health Service Line, Veterans Affairs Atlanta Healthcare System, Decatur, Georgia
                [2 ]Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
                [3 ]Consulting for Statistics, Computing and Analytics Research, University of Michigan, Ann Arbor
                [4 ]Mental Health Service Line, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
                [5 ]Department of Psychiatry, Medical University of South Carolina, Charleston
                [6 ]Department of Psychiatry, Massachusetts General Hospital, Boston
                [7 ]Department of Psychiatry, New York University School of Medicine, New York
                [8 ]College of Nursing, Medical University of South Carolina, Charleston
                [9 ]Mental Health Service Line, Veterans Affairs San Diego Healthcare System, San Diego, California
                [10 ]School of Medicine, University of California, San Diego, La Jolla
                [11 ]Veterans Affairs Center of Excellence for Stress and Mental Health, San Diego, California
                [12 ]Department of Psychiatry, University of Michigan, Ann Arbor
                [13 ]Department of Psychiatry, University of Illinois at Chicago
                [14 ]Mental Health Service Line, Jesse Brown Veterans Affairs Medical Center, Chicago, Illinois
                [15 ]Walter Reed Army Institute of Research, Silver Spring, Maryland
                Article
                DOI: 10.1001/jamapsychiatry.2018.3412
                PMC ID: 6439753
                PubMed ID: 30516797
                SO-VID: 578e4ec2-acfc-418a-af3b-63598216effc
                Copyright © © 2018
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