Posttraumatic stress disorder treatment preference: Prolonged exposure therapy, cognitive processing therapy, or medication therapy?

Abstract

To investigate preferences for evidence-based treatments for posttraumatic stress disorder (PTSD) and the role of likely PTSD in those preferences. Undergraduate students (N = 119) and participants recruited from trauma support groups (N = 126) read descriptions of front-line recommended treatments for PTSD, including prolonged exposure therapy (PE), cognitive-processing therapy (CPT), and medication therapy (MT). Participants selected their treatment of choice and provided ratings of the credibility and their personal reactions to each treatment. Participants generally preferred psychotherapeutic treatments (CPT and PE) over MT, and this finding persisted when considering likely PTSD. Trauma support group participants and students with no likely PTSD showed preference towards CPT over PE, and students with likely PTSD preferred both CPT and PE over MT. In both groups, credibility and personal reaction ratings were also generally higher for the psychotherapeutic treatments than MT, with the highest ratings of credibility and personal reactions for CPT. There was a significant interaction between treatment type and likely PTSD for credibility and personal reaction ratings among students, such that students with likely PTSD had lower credibility and personal reaction ratings to MT. Determining preference for PTSD treatment has important implications for maximizing treatment efficacy, adherence, and engagement. Our results indicate that individuals generally prefer psychotherapeutic treatments, highlighting the need to increase the availability and utilization of evidence-based psychotherapeutic treatments for PTSD.

The interactions between patient preferences, expectancies, and stigma contribute to posttraumatic stress disorder treatment outcomes

“…The credibility of and expectancy regarding therapy have been shown to coincide with treatment choices among women with a diagnosis of PTSD (Feeny et al., 2009; Zoellner et al., 2003); however, among a sample of veterans (Kehle‐Forbes et al., 2022), discrepancies have been found between credibility and perceived expectancies regarding descriptions of therapeutic interventions for PTSD. In a separate study, credibility appeared to influence participants’ preference for a trauma‐focused intervention over medication therapy (Shifrin et al., 2023). Yet, these factors have not been examined in the context of a clinical trial among active duty service members and veterans suffering from PTSD.…”