title: Investigating Relationships Between PTSD Symptom Clusters Within Virtual Reality Exposure Therapy for OEF/OIF Veterans.
abstract: Several cognitive behavioral therapeutic approaches have been demonstrated to be effective in reducing post-traumatic stress disorder (PTSD) symptoms (Foa, Keane, Friedman, & Cohen, 2008). The bulk of PTSD treatment research has relied on pre-post designs, which are limited in their ability to investigate the therapeutic process over time. The present study investigated the relations between PTSD symptom clusters using symptom assessment at pretreatment, midtreatment, and posttreatment using cross-lagged panel design over the course of Virtual Reality Exposure (VRE) treatment. Participants were 156 Iraq and/or Afghanistan veterans who met DSM-IV criteria for PTSD due to military trauma. Using structural equation modeling, the final reexperiencing model demonstrated good fit, χ2(34)=39.95, p=.22; RMSEA=.034, 90% CI: [0.00, 0.07], CFI=.993, and results suggested that reexperiencing at pretreatment demonstrated a significant effect on numbing, avoidance, hyperarousal at midtreatment, and reexperiencing symptoms at midtreatment demonstrate a significant effect on each of the three symptom clusters at posttreatment. These findings suggest that reexperiencing symptoms are indeed a key aspect of the therapeutic process within exposure therapy for PTSD. Additional research examining the impact of reexperiencing-focused intervention strategies on treatment outcomes is warranted.
authors.affiliation: University of Georgia. Electronic address: jessmaples@gmail.com.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Maples-Keller
authors.affiliation: University of Vermont.
authors.forename: Matthew
authors.initials: M
authors.lastname: Price
authors.affiliation: Emory University School of Medicine.
authors.forename: Sheila
authors.initials: S
authors.lastname: Rauch
authors.affiliation: Emory University School of Medicine.
authors.forename: Maryrose
authors.initials: M
authors.lastname: Gerardi
authors.affiliation: Emory University School of Medicine.
authors.forename: Barbara O
authors.initials: BO
authors.lastname: Rothbaum
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D015928:Cognitive Behavioral Therapy / Q000379:methods; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology*; D063367:Virtual Reality Exposure Therapy / Q000379:methods*
keywords: PTSD; prolonged exposure; symptom clusters; treatment response; virtual reality