title: Work-related outcomes among female veterans and service members after treatment of posttraumatic stress disorder.
abstract: OBJECTIVE
  This study examined the effect of treatment for posttraumatic stress disorder (PTSD) on work-related quality-of-life outcomes and the relationship between clinically significant change during treatment and work-related outcomes. Additional analyses explored whether current depression and employment status moderated the effects of treatment and clinically significant change.
  
  
  METHODS
  Participants were 218 female veterans and soldiers with current PTSD who participated in a randomized clinical trial of treatment for PTSD. They received ten weekly sessions of prolonged exposure or present-centered therapy and were assessed before and after treatment and at three- and six-month follow-ups. Outcomes were clinician-rated and self-rated occupational impairment and self-rated satisfaction with work.
  
  
  RESULTS
  Both treatment groups had improvements in occupational impairment, and the degree of improvement by the two groups was similar. There was no pre- to posttreatment change in work satisfaction. At the end of treatment, participants who no longer met diagnostic criteria for PTSD had greater improvements in all domains of work-related quality of life than participants who still had PTSD.
  
  
  CONCLUSIONS
  Although prolonged exposure resulted in better PTSD symptom outcomes than present-centered therapy in the randomized clinical trial, it did not result in better work-related quality-of-life outcomes. The improvement in occupational impairment associated with loss of diagnosis suggests the importance of continuing treatment until clinically meaningful change has been attained.
authors.affiliation: National Center for PTSD, U.S. Department of Veterans Affairs Medical Center, 116D, 215 N. Main St., White River Junction, VT 05009, USA. paula.schnurr@dartmouth.edu
authors.forename: Paula P
authors.initials: PP
authors.lastname: Schnurr
authors.forename: Carole A
authors.initials: CA
authors.lastname: Lunney
mesh_terms: D000328:Adult; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology; D003887:Desensitization, Psychologic; D004651:Employment / Q000523:psychology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D007588:Job Satisfaction; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011788:Quality of Life; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D014728:Veterans / Q000523:psychology*