title: High rates of PTSD treatment dropout: A possible red herring?
abstract: Few studies have examined symptom change among dropouts from posttraumatic stress disorder (PTSD) treatment. However, dropout is widely considered a negative event needing to be addressed. The present study investigated PTSD and depression symptom change in patients with PTSD who discontinued psychotherapy. Female civilians (n=321) diagnosed with PTSD participated in two randomized clinical trials examining PTSD treatment outcomes. Of those, 53 were identified as dropouts and included in this study. Symptom change was assessed by clinically significant change (CSC) criteria and symptom end-state criteria. Results demonstrated that considerable proportions of participants (35.85-55.56%) displayed significant improvement and/or met good end-state criteria for PTSD and depression. Results also revealed that participants who displayed symptom improvement were younger, attended more treatment sessions, were married or partnered, and had higher annual household income. Although preliminary, these findings contradict belief that treatment dropouts do not display symptom improvement.
authors.affiliation: Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States. Electronic address: Derek.Szafranski@va.gov.
authors.forename: Derek D
authors.initials: DD
authors.lastname: Szafranski
authors.affiliation: National Center for PTSD, VA Boston Healthcare System, Boston, MA, United States; Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States. Electronic address: Brian.Smith12@va.gov.
authors.forename: Brian N
authors.initials: BN
authors.lastname: Smith
authors.affiliation: Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States. Electronic address: grosd@musc.edu.
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Gros
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, United States. Electronic address: Patricia.Resick@duke.edu.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Resick
mesh_terms: D000328:Adult; D000367:Age Factors; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D017533:Marital Status; D008875:Middle Aged; D010352:Patient Dropouts / Q000523:psychology*; D011613:Psychotherapy / Q000379:methods*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cognitive processing therapy; Dropout; Posttraumatic stress disorder; Prolonged exposure