Review of exposure therapy: A gold standard for PTSD treatment

Abstract

Abstract-Prolonged exposure (PE) is an effective first-line treatment for posttraumatic stress disorder (PTSD), regardless of the type of trauma, for Veterans and military personnel. Extensive research and clinical practice guidelines from various organizations support this conclusion. PE is effective in reducing PTSD symptoms and has also demonstrated efficacy in reducing comorbid issues such as anger, guilt, negative health perceptions, and depression. PE has demonstrated efficacy in diagnostically complex populations and survivors of single-and multiple-incident traumas. The PE protocol includes four main therapeutic components (i.e., psychoeducation, in vivo exposure, imaginal exposure, and emotional processing). In light of PE's efficacy, the Veterans Health Administration designed and supported a PE training program for mental health professionals that has trained over 1,300 providers. Research examining the mechanisms involved in PE and working to improve its acceptability, efficacy, and efficiency is underway with promising results.

Cognitive-behavioral therapy for sleep disturbances in treating posttraumatic stress disorder symptoms: A meta-analysis of randomized controlled trials

“…We found no difference in the study attrition rate between the treatment and control groups at posttreatment. PTSD treatments can have relatively higher attrition rates, ranging from 20% to 38% (Hembree et al, 2003;Rauch, Eftekhari, & Ruzek, 2012). The dropout rate of group-based PTSD treatments is similar (26.5%) (Sloan et al, 2013).…”

Taking the Pulse of Prolonged Exposure Therapy: Physiological Reactivity to Trauma Imagery as an Objective Measure of Treatment Response

“…PE is considered a gold-standard treatment [34][35][36][37][38] and is being disseminated widely in Department of Veterans Affairs (VA) [39] and Department of Defense (DoD) [40] contexts, thus creating a sound platform for scientific replication. Throughout PE, symptom remission is facilitated via emotional processing of trauma memories and concomitant extinction learning, accomplished by systematically confronting subjectively distressing, but objectively safe, trauma-related situations (in vivo exposure), and by repeatedly recounting trauma memories (imaginal exposure).…”

Onset, timing, and exposure therapy of stress disorders: mechanistic insight from a mathematical model of oscillating neuroendocrine dynamics

“…Both therapies involve re-experiencing stressful situations directly or through imagination, and have been consistently proven effective as first-line treatments for PTSD symptoms [55][56][57]. Our results suggest that ET can directly alter and "decouple" the expression of cortisol from an underlying upstream disorder.…”