(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 (Davidson et at., 1991; Breslau et al., 1991, 1998; Kessler et al., 1995). 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.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
1R01MH066348-01A2
Application #
6727917
Study Section
Interventions Research Review Committee (ITV)
Program Officer
Street, Linda L
Project Start
2004-01-01
Project End
2008-12-31
Budget Start
2004-01-01
Budget End
2004-12-31
Support Year
1
Fiscal Year
2004
Total Cost
$305,775
Indirect Cost
Name
Case Western Reserve University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
077758407
City
Cleveland
State
OH
Country
United States
Zip Code
44106
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
Kline, Alexander C; Cooper, Andrew A; Rytwinksi, Nina K et al. (2018) Long-term efficacy of psychotherapy for posttraumatic stress disorder: A meta-analysis of randomized controlled trials. Clin Psychol Rev 59:30-40
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
Graham, Belinda; Garcia, Natalia M; Burton, Mark S et al. (2018) High expectancy and early response produce optimal effects in sertraline treatment for post-traumatic stress disorder. Br J Psychiatry 213:704-708
Cooper, Andrew A; Kline, Alexander C; Graham, Belinda et al. (2017) Homework ""Dose,"" Type, and Helpfulness as Predictors of Clinical Outcomes in Prolonged Exposure for PTSD. Behav Ther 48:182-194
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; Clifton, Erin G; Feeny, Norah C (2017) An empirical review of potential mediators and mechanisms of prolonged exposure therapy. Clin Psychol Rev 56:106-121
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

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