Prolonged Exposure Therapy With Veterans and Active Duty Personnel Diagnosed With PTSD and Traumatic Brain Injury.
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| Title: | Prolonged Exposure Therapy With Veterans and Active Duty Personnel Diagnosed With PTSD and Traumatic Brain Injury. |
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| Authors: | Wolf, Gregory K., Kretzmer, Tracy, Crawford, Eric, Thors, Christina, Wagner, H. Ryan, Strom, Thad Q., Eftekhari, Afsoon, Klenk, Megan, Hayward, Laura, Vanderploeg, Rodney D. |
| Source: | Journal of Traumatic Stress. Aug2015, Vol. 28 Issue 4, p339-347. 9p. 2 Charts. |
| Subjects: | Social conditions of veterans, Sexual harassment, Mental health of veterans, Mental health & society, Brain metabolism |
| Abstract (English): | The present study used archival clinical data to analyze the delivery and effectiveness of prolonged exposure (PE) and ancillary services for posttraumatic stress disorder (PTSD) among Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans ( N = 69) with histories of mild to severe traumatic brain injury (TBI). Data from standard clinical assessments of veterans and active duty personnel treated in both inpatient and outpatient programs at 2 Department of Veteran Affairs medical centers were examined. Symptoms were assessed with self-report measures of PTSD (PTSD Checklist) and depression (Beck Depression Inventory-II) before and throughout therapy. Mixed linear models were utilized to determine the slope of reported symptoms throughout treatment, and the effects associated with fixed factors such as site, treatment setting (residential vs. outpatient), and TBI severity were examined. Results demonstrated significant decreases in PTSD, B = −3.00, 95% CI [−3.22, −2.78]; t(210) = −13.5; p < .001, and in depressive symptoms, B = −1.46, 95% CI [−1.64, −1.28]; t(192) = −8.32; p < .001. The effects of PE treatment did not differ by clinical setting and participants with moderate to severe injuries reported more rapid gains than those with a history of mild TBI. The results provide evidence that PE may well be effective for veterans with PTSD and TBI. [ABSTRACT FROM AUTHOR] |
| Abstract (Spanish): | Resumen TERAPIA DE EXPOSICIÓN PROLONGADA CON VETERANOS CON LCT El presente estudio utilizo archivos de datos clínicos para analizar la entrega y efectividad de la exposición prolongada (EP) y servicios auxiliares para el trastorno por estrés postraumático (TEPT) entre veteranos de la Operación Libertad Duradera (OLD), la Operación de Liberación Iraqui (OLI) y la Operación Nuevo Amanecer (ONA) (N = 69) con historias de lesión cerebral traumática (LCT) leve a severa. Se examinaron los datos de evaluaciones clínicas estándares de veteranos y personal en servicio activo tratados en programas de atención hospitalaria y ambulatoria en dos centros médicos de departamento de asuntos veteranos. Los síntomas fueron evaluados con mediciones de autoreporte de TEPT (TEPT lista de verificación) y depresión (Inventario de depresión Beck-II) antes y durante la terapia. Modelos lineales mixtos fueron utilizados para determinar la pendiente de los síntomas reportados a través del tratamiento y los efectos asociados a factores fijos como el sitio, entorno del tratamiento (residencial o ambulatorio) y la severidad de la LCT. Los resultados demostraron disminuciones significativas en el TEPT, b = -3.00, 95% CI[-3.22,-2.78]; t(210) = -13.5; p<.001, y en los síntomas depresivos, b = -1.46, 95% CI[-1.64,-1.28]; t(192) = -8.32; p<.001. Los efectos del tratamiento de EP de acuerdo al entorno clínico y participantes con daño moderado o severo reportaron aumentos más rápidos que aquellos con historia de LCT leve. Estos resultados proporcionan evidencia de que la EP puede ser efectiva para veteranos con TEPT y LCT. [ABSTRACT FROM AUTHOR] |
| Abstract (Chinese): | Traditional and Simplified Chinese Abstracts by AsianSTSS 標題 : 為診斷出有PTSD及創傷性腦損傷的退役軍人提供持續暴露療法 撮要: 本研究檢視曾患輕微至嚴重創傷性腦損傷(TBI)的OEF、OIF及OND退役軍人(N = 69)，利用臨床的檔案數據分析持續暴露療法(PE)及為創傷後壓力症(PTSD)患者提供的輔助服務的提供方法及效用。研究檢視退伍軍人事務部兩個醫療中心的住院及門診醫療計劃中，受治療的現役及退役軍人的標準臨床評估數據。在療程進行前及期間，研究透過患者自評測量PTSD（PTSD檢查表）及抑鬱症（貝克抑鬱量表第二版）來評估他們的症狀，使用混合線性模型找出療程中報有症狀的斜率，並檢視與固定因素相關的效應，如地點、療程設定（住院或門診治療）及TBI嚴重度。結果顯示PTSD症狀顯著下降b = -3.00, 95% CI [-3.22, -2.78]; t(210) = -13.5; p < .001，抑鬱症狀亦顯著下降b = -1.46, 95% CI [-1.64, -1.28]; t(192) = -8.32; p < .001。接受臨床的PE治療、有中度至嚴重損傷的患者，比曾患輕微TBI的患者報有更快的康復。結果證明PE對有PTSD和TBI的退役軍人亦可能有效。 标题 : 为诊断出有PTSD及创伤性脑损伤的退役军人提供持续暴露疗法 撮要: 本研究检视曾患轻微至严重创伤性脑损伤(TBI)的OEF、OIF及OND退役军人(N = 69)，利用临床的档案数据分析持续暴露疗法(PE)及为创伤后压力症(PTSD)患者提供的辅助服务的提供方法及效用。研究检视退伍军人事务部两个医疗中心的住院及门诊医疗计划中，受治疗的现役及退役军人的标准临床评估数据。在疗程进行前及期间，研究透过患者自评测量PTSD（PTSD检查表）及抑郁症（贝克抑郁量表第二版）来评估他们的症状，使用混合线性模型找出疗程中报有症状的斜率，并检视与固定因素相关的效应，如地点、疗程设定（住院或门诊治疗）及TBI严重度。结果显示PTSD症状显著下降b = -3.00, 95% CI [-3.22, -2.78]; t(210) = -13.5; p < .001，抑郁症状亦显著下降b = -1.46, 95% CI [-1.64, -1.28]; t(192) = -8.32; p < .001。接受临床的PE治疗、有中度至严重损伤的患者，比曾患轻微TBI的患者报有更快的康复。结果证明PE对有PTSD和TBI的退役军人亦可能有效。 [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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| Abstract: | The present study used archival clinical data to analyze the delivery and effectiveness of prolonged exposure (PE) and ancillary services for posttraumatic stress disorder (PTSD) among Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans ( N = 69) with histories of mild to severe traumatic brain injury (TBI). Data from standard clinical assessments of veterans and active duty personnel treated in both inpatient and outpatient programs at 2 Department of Veteran Affairs medical centers were examined. Symptoms were assessed with self-report measures of PTSD (PTSD Checklist) and depression (Beck Depression Inventory-II) before and throughout therapy. Mixed linear models were utilized to determine the slope of reported symptoms throughout treatment, and the effects associated with fixed factors such as site, treatment setting (residential vs. outpatient), and TBI severity were examined. Results demonstrated significant decreases in PTSD, B = −3.00, 95% CI [−3.22, −2.78]; t(210) = −13.5; p < .001, and in depressive symptoms, B = −1.46, 95% CI [−1.64, −1.28]; t(192) = −8.32; p < .001. The effects of PE treatment did not differ by clinical setting and participants with moderate to severe injuries reported more rapid gains than those with a history of mild TBI. The results provide evidence that PE may well be effective for veterans with PTSD and TBI. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 08949867 |
| DOI: | 10.1002/jts.22029 |
