Prolonged exposure therapy for combat-related posttraumatic stress disorder: Comparing outcomes for veterans of different wars.

Abstract

There is significant support for exposure therapy as an effective treatment for posttraumatic stress disorder (PTSD) across a variety of populations, including veterans; however, there is little empirical information regarding how veterans of different war theaters respond to exposure therapy. Accordingly, questions remain regarding therapy effectiveness for treatment of PTSD for veterans of different eras. Such questions have important implications for the dissemination of evidence based treatments, treatment development, and policy. The current study compared treatment outcomes across 112 veterans of the Vietnam War, the first Persian Gulf War, and the wars in Afghanistan and Iraq. All subjects were diagnosed with PTSD and enrolled in Prolonged Exposure (PE) treatment. Veterans from all three groups showed significant improvement in PTSD symptoms, with veterans from Vietnam and Afghanistan/Iraq responding similarly to treatment. Persian Gulf veterans did not respond to treatment at the same rate or to the same degree as veterans from the other two eras. Questions and issues regarding the effectiveness of evidence based treatment for veterans from different eras are discussed.

Effectiveness of Cognitive Processing Therapy and Prolonged Exposure in the Department of Veterans Affairs

“…Older veterans did have significantly higher self-reported PTSD symptoms, but that main effect was not present in the final multilevel model due to the inclusion of initial PTSD symptom severity as a separate variable. Prior studies Yoder et al, 2012) Race/Ethnicity and treatment outcomes. Regarding the association between race/ethnicity and treatment outcomes, there have been some conflicting results in the literature.…”

“…Multiple studies have been conducted with combat veterans in the VA system (Eftekhari et al, 2013;Goodson et al, 2013;Rauch et al, 2009;Tuerk et al, 2011;Yoder et al, 2012). All of the effectiveness studies carried out with vetrans have shown that PE is an effective treatment for PTSD.…”

Psychotherapy for military-related posttraumatic stress disorder: Review of the evidence

“…First, Tuerk et al (2011) showed large reductions in self-reported PTSD symptoms from pre-to post-treatment in OIF/OEF veterans (N = 65). Second, to examine possible differences in effectiveness across military cohorts, Yoder et al (2012) compared PE outcomes for new veterans, Persian Gulf war veterans, and Vietnam veterans (N = 112). Effect sizes were large for all three groups, and largest in new veterans.…”

Utilizing Telehealth to Support Treatment of Acute Stress Disorder in a Theater of War: Prolonged Exposure via Clinical Videoconferencing

“…[7][8][9][10][11] PE demonstrates effect sizes of over 1 standard deviation improvement from baseline in intent-to-treat samples and 2 standard deviations improvement for treatment completers. 7,8,10,[12][13][14][15] Moreover, the protocol has been shown to be particularly effective in normative treatment settings for Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF)-related PTSD. 10,[12][13][14][15] Failing to diagnose and treat stress disorders in combat settings represents a missed opportunity, as time-limited treatment can increase functionality, 16 decrease the need for future mental health services, 17 and, in cases of ASD, prevent the subsequent onset of PTSD.…”