Randomized Trial of Trauma-Focused Group Therapy for Posttraumatic Stress Disorder

Schnurr, Paula P.; Friedman, Matthew J.; Foy, David W.; Shea, M. Tracie; Hsieh, F.; Lavori, Philip W.; Glynn, Shirley M.; Wattenberg, Melissa S.; Bernardy, Nancy C.

doi:10.1001/archpsyc.60.5.481

Cited by 390 publications

(346 citation statements)

References 31 publications

(37 reference statements)

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“…Details about the procedures and the results of the original studies have been published elsewhere [19][20]. All participants in these studies gave informed consent prior to participation.…”

Section: Methodsmentioning

confidence: 99%

“…Male participants were 358 Vietnam veterans who took part in a randomized clinical trial of group psychotherapy for PTSD [19]. Inclusion criteria in the treatment study were current combat-related PTSD according to the "1/2" rule on the Clinician-Administered PTSD Scale (CAPS) [28]; agreement to not receive other psychotherapy for PTSD during study treatment; and, for those on psychoactive medication, a stable regimen for the preceding 2 months.…”

Section: Participantsmentioning

confidence: 99%

“…Previous longitudinal analyses involving this sample excluded veterans who did not participate in follow-up assessments [6,19,29]. Because the current project focused on pretreatment symptoms and quality of life, our sample included most of the participants from the original sample of 360, excluding 2 men who were missing the quality of life measure.…”

Section: Participantsmentioning

confidence: 99%

“…Interrater reliability was high in both of the original studies [19][20]. Severity scores were calculated for four PTSD symptom clusters.…”

Section: Ptsd Symptomsmentioning

confidence: 99%

“…In the first study, 360 male Vietnam veterans were randomly assigned to receive 30 weekly sessions of either trauma-focused group therapy or present-centered group therapy followed by five monthly booster sessions [19]. In the second study [20], 284 female veterans were randomly assigned to receive 10 weekly individual sessions of prolonged exposure [21] or present-centered therapy.…”

Section: Introductionmentioning

confidence: 99%

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Exploration of gender differences in how quality of life relates to posttraumatic stress disorder in male and female veterans

Schnurr

Lunney²

2008

JRRD

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Abstract-Significant gaps exist in our knowledge about gender differences in quality of life among individuals with posttraumatic stress disorder (PTSD). We addressed these gaps by using data from two randomized clinical trials of veterans treated in Department of Veterans Affairs settings: 358 male Vietnam veterans who received group therapy and 203 female veterans who received individual psychotherapy. Using confirmatory factor analysis, we found that a four-factor structure for the Quality of Life Inventory provided the best fit for both groups. Overall quality of life was poor in men and women, and in general, they did not differ in quality of life or in how PTSD was associated with quality of life; the few statistically significant differences were small and clinically insignificant. For both men and women, numbing was uniquely associated with reduced quality of life. We suggest that quality of life should receive increased attention in research and clinical efforts to help veterans with PTSD. Clinical Trial

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Section: Methodsmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

“…Interrater reliability was high in both of the original studies [19][20]. Severity scores were calculated for four PTSD symptom clusters.…”

Section: Ptsd Symptomsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Exploration of gender differences in how quality of life relates to posttraumatic stress disorder in male and female veterans

Schnurr

Lunney²

2008

JRRD

Self Cite

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Integrating Tobacco Cessation Into Mental Health Care for Posttraumatic Stress Disorder<subtitle>A Randomized Controlled Trial</subtitle>

McFall

Saxon

Malte

et al. 2010

JAMA

196

168

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Mindfulness-Based Stress Reduction for Posttraumatic Stress Disorder Among Veterans

Polusny

Erbes

Thuras

et al. 2015

JAMA

256

230

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IMPORTANCE Mindfulness-based interventions may be acceptable to veterans who have poor adherence to existing evidence-based treatments for posttraumatic stress disorder (PTSD). OBJECTIVE To compare mindfulness-based stress reduction with present-centered group therapy for treatment of PTSD. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial of 116 veterans with PTSD recruited at the Minneapolis Veterans Affairs Medical Center from March 2012 to December 2013. Outcomes were assessed before, during, and after treatment and at 2-month follow-up. Data collection was completed on April 22, 2014.INTERVENTIONS Participants were randomly assigned to receive mindfulness-based stress reduction therapy (n = 58), consisting of 9 sessions (8 weekly 2.5-hour group sessions and a daylong retreat) focused on teaching patients to attend to the present moment in a nonjudgmental, accepting manner; or present-centered group therapy (n = 58), an active-control condition consisting of 9 weekly 1.5-hour group sessions focused on current life problems. MAIN OUTCOMES AND MEASURESThe primary outcome, change in PTSD symptom severity over time, was assessed using the PTSD Checklist (range, 17-85; higher scores indicate greater severity; reduction of 10 or more considered a minimal clinically important difference) at baseline and weeks 3, 6, 9, and 17. Secondary outcomes included PTSD diagnosis and symptom severity assessed by independent evaluators using the Clinician-Administered PTSD Scale along with improvements in depressive symptoms, quality of life, and mindfulness.RESULTS Participants in the mindfulness-based stress reduction group demonstrated greater improvement in self-reported PTSD symptom severity during treatment (change in mean PTSD Checklist scores from 63.6 to 55.7 vs 58.8 to 55.8 with present-centered group therapy; between-group difference, 4.95; 95% CI, 1.92-7.99; P=.002) and at 2-month follow-up (change in mean scores from 63.6 to 54.4 vs 58.8 to 56.0, respectively; difference, 6.44; 95% CI, 3.34-9.53, P < .001). Although participants in the mindfulness-based stress reduction group were more likely to show clinically significant improvement in self-reported PTSD symptom severity (48.9% vs 28.1% with present-centered group therapy; difference, 20.9%; 95% CI, 2.2%-39.5%; P = .03) at 2-month follow-up, they were no more likely to have loss of PTSD diagnosis (53.3% vs 47.3%, respectively; difference, 6.0%; 95% CI, −14.1% to 26.2%; P = .55).CONCLUSIONS AND RELEVANCE Among veterans with PTSD, mindfulness-based stress reduction therapy, compared with present-centered group therapy, resulted in a greater decrease in PTSD symptom severity. However, the magnitude of the average improvement suggests a modest effect.

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Randomized Trial of Trauma-Focused Group Therapy for Posttraumatic Stress Disorder

Abstract: This study did not find a treatment effect for trauma-focused group therapy. The difference between the effectiveness and adequate dose findings suggests the possible value of methods to enhance the delivery of cognitive-behavioral treatments in clinical practice settings.

Cited by 390 publications

References 31 publications

Exploration of gender differences in how quality of life relates to posttraumatic stress disorder in male and female veterans

Exploration of gender differences in how quality of life relates to posttraumatic stress disorder in male and female veterans

Integrating Tobacco Cessation Into Mental Health Care for Posttraumatic Stress Disorder<subtitle>A Randomized Controlled Trial</subtitle>

Mindfulness-Based Stress Reduction for Posttraumatic Stress Disorder Among Veterans

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