Effect of Group vs Individual Cognitive Processing Therapy in Active-Duty Military Seeking Treatment for Posttraumatic Stress Disorder

Abstract

clinicaltrials.gov identifier: NCT02173561.

Examining the effectiveness of an intensive, 2‐week treatment program for military personnel and veterans with PTSD: Results of a pilot, open‐label, prospective cohort trial

“…Long‐term follow‐up studies conducted in nonmilitary samples suggest the beneficial effects of CPT endure for up to 10 years posttreatment (Resick, Williams, Suvak, Monson, & Gradus, ). More recent studies indicate CPT is also associated with significant reductions in suicide ideation (Bryan et al., ; Gradus, Suvak, Wisco, Marx, & Resick, ; Resick et al., ), potentially due to its effects on PTSD and depression symptom severity (Bryan et al., ; Gradus et al., ). In light of these empirical findings, the VA/DOD Clinical Practice Guideline for the Management of Posttraumatic Stress (Department of Veterans Affairs & Department of Defense, ) recommends CPT as a first‐line treatment for military personnel and veterans with PTSD.…”

Residual Sleep Problems Predict Reduced Response to Prolonged Exposure among Veterans with PTSD

“…Despite large effect sizes observed across empirically supported treatments for PTSD (Bradley, Greene, Russ, Dutra, & Westen, 2005; Powers, Halpern, Ferenschak, Gilihan, & Foa, 2010), there is still much room for improvement. A close examination of clinical trials reveals that a sub-set of patients drop out of treatment (ranging from 20–40% in military populations; Gros, Price, Yuen, & Acierno, 2013; Reger et al, 2016; Resick et al, 2016; Steenkamp, Litz, Hoge, & Marmar, 2015; Hembree et al, 2003), and a sub-set of patients who complete empirically supported treatments are non-responsive, with 20–35% of patients still meeting diagnostic criteria for PTSD after treatment completion (Cahill & Foa, 2004). Similarly, a review of 55 clinical trials testing empirically supported treatments for PTSD concluded that, “nonresponse rates exceeded 50% on at least some measures in many studies” (p. 136, Schottenbauer, Glass, Arnkoff, Tendick, & Gray, 2008).…”

Changes in anger and aggression after treatment for PTSD in active duty military

“…All participants met criteria for PTSD based on the PTSD Symptom Scale Interview (PSSI: Foa, Riggs, Dancu, & Rothbaum, ) that was administered by a trained and supervised master‐ or doctoral‐level independent evaluator who was unaware of treatment condition. Interrater reliability for the PSSI was very good (Cohen's κ = .83 and .89 for Resick et al, and Resick et al, , respectively). Participants taking psychotropic medications were required to be on a stable dosage for 6 weeks before study entry and were asked to remain on an unchanging regimen throughout the treatment.…”

“…This study was a secondary data analysis of combined samples from RCTs that compared CPT administered in a group format to PCT administered in a group format (Study 1; Resick et al, ) and CPT administered in a group format to CPT administered in an individual format (Study 2; Resick et al, ) in active duty service members (see Table ). Details regarding the South Texas Research Organizational Network Guiding Studies on Trauma and Resilience (STRONG STAR; http://www.STRONGSTAR.org) parent trials are described in detail elsewhere (Resick et al, ). Participants were 374 active duty U.S. service members (91% male) seeking treatment for PTSD; all participants served at least one deployment in support of combat operations following 9/11.…”

“…Because anger and aggression may be adaptive in future combat situations, service members may respond differently to PTSD treatments. The first aim of the current study was to examine changes in anger and aggression as separate constructs for active duty service members who took part in two RCTs designed to study the efficacy of CPT (group and individual) for PTSD (Resick et al, ). A detailed explanation of CPT is beyond the scope of this manuscript (see Resick et al, for more information).…”