1. Massed v. standard prolonged exposure therapy for PTSD in military personnel and veterans: 12-month follow-up of a non-inferiority randomised controlled trial.
- Author
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Dell, Lisa, Sbisa, Alyssa M., Forbes, Andrew, O'Donnell, Meaghan, Bryant, Richard, Hodson, Stephanie, Morton, David, Battersby, Malcolm, Tuerk, Peter W., Elliott, Peter, Wallace, Duncan, and Forbes, David
- Subjects
TREATMENT of post-traumatic stress disorder ,RESEARCH ,BEHAVIOR therapy ,RANDOMIZED controlled trials ,COMPARATIVE studies ,PRE-tests & post-tests ,TREATMENT effectiveness ,SEVERITY of illness index ,MENTAL depression ,QUALITY of life ,RESEARCH funding ,VETERANS ,STATISTICAL sampling ,ANXIETY ,ANGER ,PEOPLE with disabilities ,MILITARY personnel - Abstract
Background: The utilisation of massed therapy for treating posttraumatic stress disorder (PTSD) is gaining strength, especially prolonged exposure. However, it is unknown whether massed prolonged exposure (MPE) is non-inferior to standard prolonged exposure (SPE) protocols in the long term. The current study aimed to assess whether MPE was non-inferior to SPE at 12 months post-treatment, and to ascertain changes in secondary measure outcomes. Methods: A multi-site non-inferiority randomised controlled trial (RCT) compared SPE with MPE in 12 clinics. The primary outcome was PTSD symptom severity (CAPS-5) at 12 months post-treatment commencement. Secondary outcome measures included symptoms of depression, anxiety, anger, disability, and quality of life at 12 weeks and 12 months post-treatment commencement. Outcome assessors were blinded to treatment allocation. The intention-to-treat sample included 138 Australian military members and veterans and data were analysed for 134 participants (SPE = 71, MPE = 63). Results: Reductions in PTSD severity were maintained at 12 months and MPE remained non-inferior to SPE. Both treatment groups experienced a reduction in depression, anxiety, anger, and improvements in quality of life at 12 weeks and 12 months post-treatment commencement. Treatment effects for self-reported disability in the SPE group at 12 weeks were not maintained, with neither group registering significant effects at 12 months. Conclusions: The emergence of massed protocols for PTSD is an important advancement. The current study provides RCT evidence for the longevity of MPE treatment gains at 12 months post-treatment commencement and demonstrated non-inferiority to SPE. Promisingly, both treatments also significantly reduced the severity of comorbid symptoms commonly occurring alongside PTSD. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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