Influence of comorbid social anxiety disorder in PTSD treatment outcomes for Prolonged Exposure in female military sexual trauma survivors with PTSD

Abstract

Objective Posttraumatic stress disorder (PTSD) is a common psychiatric disorder that frequently presents alongside other comorbid diagnoses. Although several evidence‐based psychotherapies have been well‐studied for PTSD, limited research has focused on the influence of diagnostic comorbidity on their outcomes. The present study sought to investigate the influence of comorbid social anxiety disorder on treatment outcomes in patients with PTSD. Methods One hundred and twelve treatment‐seeking female veteran participants with PTSD completed baseline assessments and received 12–15 sessions of Prolonged Exposure. Symptom measures were completed biweekly as well as at immediate posttreatment, 3‐month, and 6‐month follow‐ups. Results Thirty (26.8%) participants seeking PTSD treatment also met diagnostic criteria for social anxiety disorder. Multilevel modeling was used to examine effects of social anxiety disorder diagnosis on post‐intervention symptoms and revealed significantly worse outcomes for symptoms of PTSD and depression in participants with comorbid PTSD and social anxiety disorder. Conclusion Consistent with previous studies of co‐occurring PTSD and depression, present findings suggest that comorbid diagnoses may adversely affect disorder‐specific treatment outcomes. As such, the presence of diagnostic comorbidity may merit further consideration and potential adaptions to the traditional, disorder‐specific assessment and treatment practices for PTSD.

Exploring trajectories in transdiagnostic behavior therapy

“…However, there may be some advantages to this approach as well given the rates of diagnostic comorbidity observed in veterans (Ginzburg et al, 2010). With patients more frequently presenting with multiple diagnoses, understanding the primary and secondary effects of psychotherapeutic practices is essential (Barlow et al, 2004;Gros et al, 2022Gros et al, , 2023. Future transdiagnostic studies should consider incorporating both transdiagnostic and disorder-specific outcome measures, with the studies to date tending to select one or the other (Barlow et al, 2017;Gros & Allan, 2019).…”

Anxiety sensitivity and social support in veterans with emotional disorders

“…Approximately 23% of veterans meet diagnostic criteria for posttraumatic stress disorder (PTSD; Fulton et al, 2015), 12% for generalized anxiety disorder (Milanak et al, 2013), 12% for depressive disorders (Liu et al, 2019), and 8% for panic disorder (Gros et al, 2011). Prevalence of comorbid emotional disorders is associated with more elevated psychopathology compared to those with single diagnoses (Gros et al, 2022). Further, rates of the triple comorbidity of PTSD, clinical anxiety, and clinical depression among veterans (26.7%-30.1%) are higher than PTSD alone or PTSD comorbid with anxiety or depression (Ginzburg et al, 2010).…”