(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)
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Rudorfer, Matthew V
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University of Washington
Schools of Arts and Sciences
United States
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Bedard-Gilligan, Michele; Garcia, Natalia; Zoellner, Lori A et al. (2018) Alcohol, cannabis, and other drug use: Engagement and outcome in PTSD treatment. Psychol Addict Behav 32:277-288
Burton, Mark S; Feeny, Norah C; Connell, Arin M et al. (2018) Exploring evidence of a dissociative subtype in PTSD: Baseline symptom structure, etiology, and treatment efficacy for those who dissociate. J Consult Clin Psychol 86:439-451
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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
Clifton, Erin G; Feeny, Norah C; Zoellner, Lori A (2017) Anger and guilt in treatment for chronic posttraumatic stress disorder. J Behav Ther Exp Psychiatry 54:9-16
Jerud, Alissa B; Farach, Frank J; Bedard-Gilligan, Michele et al. (2017) Repeated trauma exposure does not impair distress reduction during imaginal exposure for posttraumatic stress disorder. Depress Anxiety 34:671-678
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

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