title: Prolonged Exposure Therapy With Veterans and Active Duty Personnel Diagnosed With PTSD and Traumatic Brain Injury.
abstract: The present study used archival clinical data to analyze the delivery and effectiveness of prolonged exposure (PE) and ancillary services for posttraumatic stress disorder (PTSD) among Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans (N = 69) with histories of mild to severe traumatic brain injury (TBI). Data from standard clinical assessments of veterans and active duty personnel treated in both inpatient and outpatient programs at 2 Department of Veteran Affairs medical centers were examined. Symptoms were assessed with self-report measures of PTSD (PTSD Checklist) and depression (Beck Depression Inventory-II) before and throughout therapy. Mixed linear models were utilized to determine the slope of reported symptoms throughout treatment, and the effects associated with fixed factors such as site, treatment setting (residential vs. outpatient), and TBI severity were examined. Results demonstrated significant decreases in PTSD, B = -3.00, 95% CI [-3.22, -2.78]; t(210) = -13.5; p < .001, and in depressive symptoms, B = -1.46, 95% CI [-1.64, -1.28]; t(192) = -8.32; p < .001. The effects of PE treatment did not differ by clinical setting and participants with moderate to severe injuries reported more rapid gains than those with a history of mild TBI. The results provide evidence that PE may well be effective for veterans with PTSD and TBI.
authors.affiliation: Mental Health & Behavioral Sciences, James A. Haley Veterans Affairs Medical Center, Tampa, Florida, USA.
authors.forename: Gregory K
authors.initials: GK
authors.lastname: Wolf
authors.affiliation: Mental Health & Behavioral Sciences, James A. Haley Veterans Affairs Medical Center, Tampa, Florida, USA.
authors.forename: Tracy
authors.initials: T
authors.lastname: Kretzmer
authors.affiliation: VA Mid-Atlantic Region Mental Illness Research, Education and Clinical Center, Durham, North Carolina, USA.|Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Crawford
authors.affiliation: Mental Health & Behavioral Sciences, James A. Haley Veterans Affairs Medical Center, Tampa, Florida, USA.
authors.forename: Christina
authors.initials: C
authors.lastname: Thors
authors.affiliation: VA Mid-Atlantic Region Mental Illness Research, Education and Clinical Center, Durham, North Carolina, USA.|Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: H Ryan
authors.initials: HR
authors.lastname: Wagner
authors.affiliation: Mental Health Services for Minneapolis, Department of Veterans Affairs Medical Center, Minneapolis, Minnesota, USA.|Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Thad Q
authors.initials: TQ
authors.lastname: Strom
authors.affiliation: Dissemination and Training Division, National Center for PTSD, VA Palo Alto HCS, Menlo Park, California, USA.
authors.forename: Afsoon
authors.initials: A
authors.lastname: Eftekhari
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Klenk
authors.affiliation: Department of Psychology, Syracuse VA Medical Center, Syracuse, New York, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Hayward
authors.affiliation: Mental Health & Behavioral Sciences, James A. Haley Veterans Affairs Medical Center, Tampa, Florida, USA.|Departments of Psychiatry and Neurosciences, and Psychology, University of South Florida, Tampa, Florida, USA.
authors.forename: Rodney D
authors.initials: RD
authors.lastname: Vanderploeg
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D001930:Brain Injuries / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D003863:Depression / Q000150:complications / Q000628:therapy; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D054542:Iraq War, 2003-2011; D008297:Male; D008889:Military Personnel / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000628:therapy*; D063189:Symptom Assessment; D013997:Time Factors; D014481:United States; D014728:Veterans / Q000523:psychology*