Deployed soldiers’ reactions to exposure and medication treatments for PTSD.

Abstract

Only a minority of service members with posttraumatic stress disorder (PTSD) access care despite growing availability of evidence-based and innovative treatments. Although preferences for military personnel have not been established, previous research on civilian populations with PTSD suggest treatment preferences for exposure-based treatments over medications. There are also unique stressors in the deployed environment that may impact treatment preferences, such as close living proximity to peers and leaders, and limited access to typical coping strategies. Soldiers deployed to Iraq (n ϭ 174) were provided a written hypothetical scenario about difficulties after combat exposure and were provided descriptions of Prolonged Exposure (PE), virtual reality exposure (VRE), and FDA-approved medications for PTSD. Soldiers completed a Treatment Reactions Scale for each treatment type. Responses were significantly more favorable for both PE and VRE relative to medications (p Ͻ .001). Relative to both exposure therapies, soldiers reacted to medications with significantly stronger agreement to scales reflecting embarrassment/shame for seeking a particular form of treatment, negative occupational/career impact, and perceived debasement for seeking the treatment. Relative to PE, soldiers were significantly less willing to recommend medication treatment and had significantly less confidence/belief in the efficacy of medications. These findings can help inform provider education of treatment options and demonstrate the importance of considering patient reactions to a treatment plan, as preferences may impact adherence.

RCT of a Brief Phone-Based CBT Intervention to Improve PTSD Treatment Utilization by Returning Service Members

“…Many Veterans have identified an unwillingness to seek treatment because they do not want to be prescribed medications (27, 28). Stigma has also been identified in the literature as influential in the decision (29, 30); however, participants in this study only infrequently identified stigma as an issue during intervention sessions (28).…”

“How Will It Help Me?”

“…They also do not speak to how a specific clinical setting impacts patient preferences. Furthermore, our sample included few individuals presenting with combat-related PTSD whose treatment preferences could systematically differ from those of non-veterans, though a recent study suggests this is not the case (Reger et al, in press). However, it is a notable strength that this is the first study to examine such reasons among PTSD patients who have the potential to receive the treatments that are described to them.…”

Acceptability of Prolonged Exposure Therapy Among U.S. Iraq War Veterans With PTSD Symptomology

“…Women reported that they chose PE because the mechanism of action made sense; specifically, women felt as though they needed to talk about their trauma to recover from it (Angelo, Miller, Zoellner, & Feeny, ). Reger and colleagues () studied 174 Operation Iraqi Freedom (OIF) soldiers’ attitudes towards PE, virtual reality exposure, and medication for the treatment of PTSD. Soldiers reported more positive attitudes towards PE and virtual reality exposure than medication across a variety of domains, including willingness to recommend the treatment and belief in treatment efficacy.…”