Residual symptoms following prolonged exposure and present‐centered therapy for PTSD in female veterans and soldiers

Paula P. Schnurr · Carole A. Lunney

105 citations0/0 files storedDepression and Anxiety

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Posttraumatic Stress Disorder Research Sleep and related disorders Psychotherapy Techniques and Applications

Abstract

BACKGROUND: Despite the effectiveness of evidence-based treatments for posttraumatic stress disorder (PTSD), some symptoms, such as sleep disturbance, can be difficult to treat regardless of treatment type. METHODS: We examined residual PTSD symptoms in 235 female veterans and soldiers who were randomized to receive 10 weekly sessions of either Prolonged Exposure (PE) or Present-Centered Therapy (PCT). PTSD symptoms were assessed using the Clinician-Administered PTSD Scale. Analyses examined the effects of PE and the effects of clinically significant improvement (loss of diagnosis, operationalized as meaningful symptom reduction and no longer meeting diagnostic criteria). RESULTS: Both treatments resulted in reductions in PTSD symptoms. PE had lower conditional probabilities than PCT of retaining intrusive memories, avoidance of people/places, detachment/estrangement, and restricted range of affect. Loss of diagnosis had lower conditional probabilities of almost all symptoms, although hyperarousal symptoms-especially irritability/anger (60.7%) and sleep difficulties (50.9%)-were the most likely to remain. CONCLUSIONS: Results are consistent with previous findings on sleep difficulties being difficult to treat, but also show that hyperarousal symptoms overall may not be resolved even after substantial improvement. Additional strategies may be needed to treat the full range of PTSD symptoms in some patients.

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References

1986Emotional processing of fear: Exposure to corrective information.1993Insomnia: Psychological Assessment and Management 2001Clinician-administered PTSD scale: A review of the first ten years of research 2007Prolonged Exposure Therapy for PTSD: Therapist Guide 2013Meta-Analysis of the Efficacy of Treatments for Posttraumatic Stress Disorder 2018Cognitive behavioral therapy for anxiety and related disorders: A meta‐analysis of randomized placebo‐controlled trials 2007Cognitive Behavioral Therapy for Posttraumatic Stress Disorder in Women 1992Uncontrollability and unpredictability in post-traumatic stress disorder: An animal model.

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2024The Psychedelic Future of Post-Traumatic Stress Disorder Treatment 2019Present-centered therapy (PCT) for post-traumatic stress disorder (PTSD) in adults 2019The impact of prolonged exposure on sleep and enhancing treatment outcomes with evidence-based sleep interventions: A pilot study.2021Insomnia disorder and its reciprocal relation with psychopathology 2020Sleep problems in active duty military personnel seeking treatment for posttraumatic stress disorder: presence, change, and impact on outcomes

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