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.
Department of Psychiatry, Weill Medical College of Cornell University, Presbyterian Hospital, New York, New York 10021, USA. jdifede@med.cornell.edu
JoAnn
J
Difede
Loretta S
LS
Malta
Suzanne
S
Best
Clare
C
Henn-Haase
Thomas
T
Metzler
Richard
R
Bryant
Charles
C
Marmar
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