title: Prolonged exposure therapy for combat- and terror-related posttraumatic stress disorder: a randomized control comparison with treatment as usual.
abstract: OBJECTIVE
  Empirically based studies have demonstrated that prolonged exposure therapy effectively reduces posttraumatic stress disorder (PTSD) symptoms in a vast range of traumas, yet reports of the efficacy of such therapies in combat- and terror-related PTSD are scarce. In this article, we examine the efficacy of prolonged exposure therapy in combat- and terror-related PTSD in comparison to treatment as usual (TAU).
  
  
  METHODS
  Between July 2002 and October 2005, 30 patients of a trauma unit within a psychiatric outpatient clinic were recruited and randomized into prolonged exposure versus TAU therapies. Patients were diagnosed with chronic PTSD (Mini-International Neuropsychiatric Interview criteria) related to combat- (n = 19) or terror-related (n = 11) trauma. Main outcome measures included symptoms of PTSD and depression, as measured by the PTSD Symptom Scale-Interview Version and the Beck Depression Inventory.
  
  
  RESULTS
  Posttraumatic stress disorder symptom severity was significantly lower in patients who received prolonged exposure therapy in comparison to patients who received TAU (F(1,24) = 35.3, P < .001). Similar results have emerged in measures of depression and state and trait anxiety. In addition, a significant change from pretreatment to follow-up was found for the prolonged exposure group (F(1,14) = 80.5, P < .0001), but not for the TAU group (F(1,10.3) = 0.6, P = .44).
  
  
  CONCLUSIONS
  Findings indicate that, similar to PTSD related to other types of trauma, prolonged exposure therapy is beneficial in the amelioration of combat- and terror-related PTSD symptoms. In addition, prolonged exposure was superior to TAU in the short- and long-term reduction of PTSD and depression symptoms.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT00229372.
authors.affiliation: Department of Psychiatry, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Nitzah
authors.initials: N
authors.lastname: Nacasch
authors.forename: Edna B
authors.initials: EB
authors.lastname: Foa
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Huppert
authors.forename: Dana
authors.initials: D
authors.lastname: Tzur
authors.forename: Leah
authors.initials: L
authors.lastname: Fostick
authors.forename: Yula
authors.initials: Y
authors.lastname: Dinstein
authors.forename: Michael
authors.initials: M
authors.lastname: Polliack
authors.forename: Joseph
authors.initials: J
authors.lastname: Zohar
mesh_terms: D000328:Adult; D003130:Combat Disorders / Q000628:therapy*; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000379:methods; D008297:Male; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*; D023481:Terrorism / Q000523:psychology; D016896:Treatment Outcome