A randomized controlled clinical treatment trial for World Trade Center attack-related PTSD in disaster workers.
This article describes a controlled clinical trial of cognitive-behavioral treatment (CBT) for disaster workers. Despite high rates of PTSD in disaster workers worldwide, there have been no randomized trials of PTSD treatment. Participants were randomly assigned to a 12-week cognitive-behavioral exposure treatment (CBT, N = 15) or a treatment-as-usual (N = 16) condition. Eight CBT and 14 treatment-as-usual participants completed treatment. An ANOVA examining changes in Clinician-Administered PTSD Scale scores found significant main effects of Time, Group, and a Time x Group interaction (p's < 0.010) with a significantly greater decline in symptom scores in the CBT group. Between-group effect sizes were large. Dropout was associated with lower income, less education, and higher alcohol consumption. This project demonstrates the feasibility of recruitment in the aftermath of a catastrophic event, the relevance of a brief focused intervention comprised of CBT and exposure, and the need to eliminate barriers to treatment retention associated with income and education.
Difede
JoAnn
J
Department of Psychiatry, Weill Medical College of Cornell University, Presbyterian Hospital, New York, New York 10021, USA. jdifede@med.cornell.edu
Malta
Loretta S
LS
Best
Suzanne
S
Henn-Haase
Clare
C
Metzler
Thomas
T
Bryant
Richard
R
Marmar
Charles
C
D015928:Cognitive Behavioral Therapy / Q000379:methods*; D004522:Educational Status; D005260:Female; D006801:Humans; D007171:Implosive Therapy; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010352:Patient Dropouts / Q000706:statistics & numerical data; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012066:Relief Work / Q000706:statistics & numerical data; D018635:Rescue Work / Q000706:statistics & numerical data*; D047851:September 11 Terrorist Attacks / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome