This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Posttraumatic stress disorder (PTSD) is a chronic and debilitating condition for which the development of efficacious and cost-effective treatments for PTSD is imperative. Both prolonged exposure therapy (PE) and Zoloft (MED) are of established efficacy for PTSD, yet little is known about the comparable effectiveness of these forms of treatment, nor what factors influence treatment acceptance/refusal and completion/drop-out. This five-year, two-site study will examine these issues. This is a collaborative R01 grant and will be conducted at the University of Washington and at Case Western Reserve University. This study is 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 PE, MED, or no treatment. In the no choice condition, participants will be randomly assigned to either PE or MED. 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. GCRC is only needed for blood and urine tests at the screening visit for those subjects starting MED therapy. 180 subjects will be enrolled at each of the two study sites.
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