title: Assessing Treatment-Resistant Posttraumatic Stress Disorder: The Emory Treatment Resistance Interview for PTSD (E-TRIP).
abstract: Patients with posttraumatic stress disorder (PTSD) who fail to respond to established treatments are at risk for chronic disability and distress. Although treatment-resistant PTSD (TR-PTSD) is a common clinical problem, there is currently no standard method for evaluating previous treatment outcomes. Development of a tool that could quantify the degree of resistance to previously provided treatments would inform research in patients with PTSD. We conducted a systematic review of PTSD treatment trials to identify medication and psychotherapy interventions proven to be efficacious for PTSD. We then developed a semi-structured clinician interview called the Emory Treatment Resistance Interview for PTSD (E-TRIP). The E-TRIP includes clinician-administered questions to assess the adequacy and benefit derived from past treatment trials. For each adequately delivered treatment to which the patient failed to respond, a score is assigned depending on the strength of evidence supporting the treatment's efficacy. The E-TRIP provides a comprehensive assessment of prior PTSD treatments that should prove valuable for researchers studying TR-PTSD and evaluating the efficacy of new treatments for patients with PTSD. The E-TRIP is not intended to guide treatment; rather, the tool quantifies the level of treatment resistance in patients with PTSD in order to standardize TR-PTSD in the research domain.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Drive, 3rd Floor, Atlanta, GA 30329, USA. bdunlop@emory.edu.
authors.forename: Boadie W
authors.initials: BW
authors.lastname: Dunlop
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Drive, 3rd Floor, Atlanta, GA 30329, USA. jlk399@drexel.edu.
authors.forename: Joanna L
authors.initials: JL
authors.lastname: Kaye
authors.affiliation: Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, USA. cyoungn@emory.edu.
authors.forename: Cole
authors.initials: C
authors.lastname: Youngner
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Drive, 3rd Floor, Atlanta, GA 30329, USA. brothba@emory.edu.
authors.forename: Barbara
authors.initials: B
authors.lastname: Rothbaum