(provided by application): Posttraumatic stress disorder (PTSD) is a chronic and debilitating condition, with lifetime prevalence rates ranging from 8%-14% of the US population. Thus, the development of efficacious and cost-effective treatments for PTSD is imperative. Both prolonged exposure therapy (PE) and sertraline (MED) are of established efficacy for PTSD. Yet, we know very little about the comparable effectiveness of these forms of treatment, nor what factors influence treatment acceptance/refusal and completion/drop-out. In this five-year, two-site study, we will examine these issues. This collaborative R01 grant will be conducted at the University of Washington under the direction of Dr. Zoellner and at Case Western Reserve University under the direction of Dr. Feeny. We will conduct a hybrid efficacy-effectiveness trial in which female and male trauma victims will be randomly assigned to either choice or no choice treatment conditions. In the choice condition, participants will choose between prolonged exposure and sertraline. In the no choice condition, participants will be randomly assigned to either prolonged exposure or sertraline. Outcome, as measured by both psychopathology and broader functioning measures, will be assessed through 24-month follow-up. The results of the proposed research will inform clinicians about the relative short-term and long-term effectiveness of PE and MED, provide information about how these treatments influence broader measures of functional impairment, provide information regarding decision making factors in order to maximize treatment utilization, and provide important information about cost effectiveness of both PE and MED for chronic PTSD.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Study Section
Interventions Research Review Committee (ITV)
Program Officer
Hsiao, John
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University of Washington
Schools of Arts and Sciences
United States
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Bergman, Hannah E; Przeworski, Amy; Feeny, Norah C (2017) Rates of Subthreshold PTSD Among U.S. Military Veterans and Service Members: A Literature Review. Mil Psychol 29:117-127
Cooper, Andrew A; Zoellner, Lori A; Roy-Byrne, Peter et al. (2017) Do changes in trauma-related beliefs predict PTSD symptom improvement in prolonged exposure and sertraline? J Consult Clin Psychol 85:873-882
Bedard-Gilligan, Michele; Zoellner, Lori A; Feeny, Norah C (2017) Is Trauma Memory Special? Trauma Narrative Fragmentation in PTSD: Effects of Treatment and Response. Clin Psychol Sci 5:212-225
Echiverri-Cohen, Aileen M; Zoellner, Lori A; Ho, William et al. (2016) An analysis of inhibitory functioning in individuals with chronic posttraumatic stress disorder. J Anxiety Disord 37:94-103
Echiverri-Cohen, Aileen; Zoellner, Lori A; Gallop, Robert et al. (2016) Changes in temporal attention inhibition following prolonged exposure and sertraline in the treatment of PTSD. J Consult Clin Psychol 84:415-26
Jerud, Alissa B; Pruitt, Larry D; Zoellner, Lori A et al. (2016) The effects of prolonged exposure and sertraline on emotion regulation in individuals with posttraumatic stress disorder. Behav Res Ther 77:62-7
Burton, Mark S; Cooper, Andrew A; Feeny, Norah C et al. (2015) The Enhancement of Natural Resilience in Trauma Interventions. J Contemp Psychother 45:193-204
Bergman, Hannah E; Kline, Alexander C; Feeny, Norah C et al. (2015) Examining PTSD treatment choice among individuals with subthreshold PTSD. Behav Res Ther 73:33-41
van Minnen, Agnes; Zoellner, Lori A; Harned, Melanie S et al. (2015) Changes in comorbid conditions after prolonged exposure for PTSD: a literature review. Curr Psychiatry Rep 17:549
Bedard-Gilligan, Michele; Duax Jakob, Jeanne M; Doane, Lisa Stines et al. (2015) An Investigation of Depression, Trauma History, and Symptom Severity in Individuals Enrolled in a Treatment Trial for Chronic PTSD. J Clin Psychol 71:725-40

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