Post-traumatic stress disorder (PTSD), a severe and chronic anxiety disorder that follows traumatic experiences (e.g., combat, physical, and sexual assault), is characterized by acute symptoms of re-experiencing, emotional numbing, avoidance, hyperarousal, and severe impairment in social functioning. There is lifetime prevalence, as high as 14% in the general population and over 30% among combat veterans. Intensive exposure therapy reduces the hallmark features of chronic PTSD (e.g., intrusions, physiological reactivity) and much of the associated general anxiety, and currently is considered the psychosocial treatment of choice. However, exposure therapy does not reduce the """"""""negative"""""""" symptoms of PTSD (e.g., avoidance, skill deficits, social isolation, interpersonal difficulties, anger control). Trauma Management Therapy (TMT), a multi-component behavioral treatment for chronic combat-related PTSD addresses all aspects of the clinical syndrome, using a combination of patient education, exposure therapy, social skills training (including emotional management) and systematic homework assignments. Preliminary evidence shows that overall TMT results in broad improvement across the wide spectrum of PTSD symptoms in veterans treated within the VA. This application is the next step in the evaluation of the efficacy of TMT. Specifically, this project is a prospective randomized study comparing TMT to Exposure Therapy only for treatment of chronic PTSD in combat veterans within the VA. Forty-eight subjects will be recruited from VA Medical Centers in Washington, D.C. Treatment will be administered over a 17-week period (active treatment phase); and subjects will be followed for an additional 12-months (follow-up phase) to ascertain long-term effects of treatment across four domains of functioning: (1) core PTSD symptoms; (2) social and emotional function; (3) symptoms of other psychiatric conditions (e.g., depression); and (4) treatment credibility and satisfaction. This application is submitted under the R21 (Exploratory/Developmental Grants) Mechanism.
| Beidel, Deborah C; Frueh, B Christopher; Uhde, Thomas W et al. (2011) Multicomponent behavioral treatment for chronic combat-related posttraumatic stress disorder: a randomized controlled trial. J Anxiety Disord 25:224-31 |
