Veterans and civilians who have posttraumatic stress disorder (PTSD) benefit equally from prolonged exposure therapy, according to a
study published this week in the
Journal of Traumatic Stress.
“Although some studies have compared [prolonged exposure therapy] outcomes for military veterans and civilian participants in community settings, none have directly compared outcomes across trauma type (combat, terror, civilian trauma) and veteran status (military vs. civilian) within the same framework,” wrote Nitsa Nacasch, M.D., of the Ramat-Chen Brüll Mental Health Center in Tel-Aviv, Israel.
Nacasch and colleagues analyzed data from 98 adults (61% male, average age of 38 years) with PTSD who received prolonged exposure therapy at one of two community mental health centers. Participants included 55 civilians and 43 military veterans who had experienced combat, terror, or civilian (such as car crashes or sexual assault) trauma. All participants had pretreatment scores of 25 or higher on the PTSD Symptom Scale-Interview Version (PSS-I).
Prolonged exposure therapy included psychoeducation, relaxation through breathing retraining, and both in vivo and imaginal exposure to traumatic memories, delivered over eight to 15 sessions. The therapy was conducted by supervised mental health professionals who had completed a four-day prolonged exposure therapy training workshop.
Though participants with combat and terror trauma reported higher pretreatment PSS-I scores, participants with all three types of trauma improved similarly over time. Average scores reduced from 32.9, 34.7, and 27.1 among groups with combat, terror, and civilian trauma, respectively, to 15.6, 15.4, and 10.6 posttreatment. Similarly, while veterans had higher average PSS-I scores than civilians pretreatment, both groups showed similar improvements posttreatment.
“These results validate [prolonged exposure therapy] as an effective treatment across trauma types, supporting its designation as a first-line therapy in guidelines and adding support for the importance of broadening access to [prolonged exposure therapy] across diverse clinical populations,” the authors concluded.