The Experts below are selected from a list of 300 Experts worldwide ranked by ideXlab platform
Norah C Feeny - One of the best experts on this subject based on the ideXlab platform.
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doubly randomized preference trial of Prolonged Exposure versus sertraline for treatment of ptsd
American Journal of Psychiatry, 2019Co-Authors: Lori A Zoellner, Matig Mavissakalian, Peter Roybyrne, Norah C FeenyAbstract:Objective:The authors examined the effect of patient treatment preference on the differential effectiveness of Prolonged Exposure and sertraline for the treatment of posttraumatic stress disorder (...
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cost effectiveness of Prolonged Exposure therapy versus pharmacotherapy and treatment choice in posttraumatic stress disorder the optimizing ptsd treatment trial a doubly randomized preference trial
The Journal of Clinical Psychiatry, 2014Co-Authors: Quang A Le, Lori A Zoellner, Jason N Doctor, Norah C FeenyAbstract:OBJECTIVE: Cost-effectiveness of treatment for posttraumatic stress disorder (PTSD) may depend on type of treatment (eg, pharmacotherapy vs psychotherapy) and patient choice of treatment. We examined the cost-effectiveness of treatment with Prolonged Exposure therapy versus pharmacotherapy with sertraline, overall treatment preference, preference for choosing Prolonged Exposure therapy, and preference for choosing pharmacotherapy with sertraline from the US societal perspective. METHOD: Two hundred patients aged 18 to 65 years with PTSD diagnosis based on DSM-IV criteria enrolled in a doubly randomized preference trial. Patients were randomized to receive their treatment of choice (n = 97) or to be randomly assigned treatment (n = 103). In the choice arm, patients chose either Prolonged Exposure therapy (n = 61) or pharmacotherapy with sertraline (n = 36). In the no-choice arm, patients were randomized to either Prolonged Exposure therapy (n = 48) or pharmacotherapy with sertraline (n = 55). The total costs, including direct medical costs, direct nonmedical costs, and indirect costs, were estimated in 2012 US dollars; and total quality-adjusted life-year (QALY) was assessed using the EuroQoL Questionnaire-5 dimensions (EQ-5D) instrument in a 12-month period. This study was conducted from July 2004 to January 2009. RESULTS: Relative to pharmacotherapy with sertraline, Prolonged Exposure therapy was less costly (-$262; 95% CI, -$5,068 to $4,946) and produced more QALYs (0.056; 95% CI, 0.014 to 0.100) when treatment was assigned, with 93.2% probability of being cost-effective at $100,000/QALY. Independently, giving a choice of treatment also yielded lower cost (-$1,826; 95% CI, -$4,634 to $749) and more QALYs (0.010; 95% CI, -0.019 to 0.044) over no choice of treatment, with 87.0% probability of cost-effectiveness at $100,000/QALY. CONCLUSIONS: Giving PTSD patients a choice of treatment appears to be cost-effective. When choice is not possible, Prolonged Exposure therapy may provide a cost-effective option over pharmacotherapy with sertraline. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00127673.
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Sudden gains in Prolonged Exposure and sertraline for chronic PTSD.
Depression and Anxiety, 2013Co-Authors: Lori A Zoellner, Norah C FeenyAbstract:Background Sudden gains are significant, rapid improvements in symptoms, larger than typical between-session symptom reduction.[8] Sudden gains in a large sample of individuals with PTSD have not been studied, and only one study has looked at it in pharmacotherapy, but not in PTSD. In the present study, we examined the occurrence of sudden gains in psychotherapy, specifically Prolonged Exposure (PE), and pharmacotherapy, specifically sertraline, for chronic PTSD.
Carmen P Mclean - One of the best experts on this subject based on the ideXlab platform.
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changes in negative cognitions mediate ptsd symptom reductions during client centered therapy and Prolonged Exposure for adolescents
Behaviour Research and Therapy, 2015Co-Authors: Carmen P Mclean, David RosenfieldAbstract:Objective To assess whether changes in negative trauma-related cognitions play an important role in reducing symptoms of posttraumatic stress disorder (PTSD) and depression during Prolonged Exposure therapy for adolescents (PE-A).
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Prolonged Exposure therapy
2015Co-Authors: Carmen P Mclean, Anu AsnaaniAbstract:Prolonged Exposure (PE) is an efficacious and effective treatment for PTSD that has been studied extensively and disseminated around the world. The theoretical underpinning of PE is emotional processing theory (EPT; Foa and Kozak 1985, 1986), an influential theory of pathological anxiety and therapeutic recovery. In this chapter, we briefly review EPT’s account of the development and treatment of PTSD. We then describe the structure and key components of PE and illustrate its delivery using a case example. Next we provide an overview of the most common challenges faced by therapists delivering PE and discuss ways of overcoming these obstacles to maximize benefit from PE. We end our discussion with a summary of the extensive evidence supporting the efficacy and effectiveness of PE for a wide range of PTSD sufferers.
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The use of Prolonged Exposure therapy to help patients with post-traumatic stress disorder
Clinical Practice, 2014Co-Authors: Carmen P McleanAbstract:Post-traumatic stress disorder (PTSD) is a chronic psychiatric disorder characterized by intrusive re-experiencing symptoms, avoidance behaviors, elevated arousal, and changes in cognition and mood. Nearly all individuals with PTSD suffer from at least one additional psychiatric diagnosis. Prolonged Exposure is one of several evidence-based treatments for PTSD that has been efficacious for PTSD sufferers with a range of comorbid disorders. In this review, we first discuss the prevalence of PTSD comorbidity and the challenges that it presents to clinicians working with traumatized patients. We then discuss the treatment of PTSD, focusing on Prolonged Exposure therapy. After providing a brief overview of PE, we review evidence supporting the use of PE in reducing PTSD severity and associated symptoms in a variety of comorbid samples.
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Prolonged Exposure vs supportive counseling for sexual abuse related ptsd in adolescent girls a randomized clinical trial
JAMA, 2013Co-Authors: Carmen P Mclean, Sandra Capaldi, David RosenfieldAbstract:Importance Evidence-based treatments for posttraumatic stress disorder (PTSD) have not been established for adolescents despite high prevalence of PTSD in this population. Objective To examine the effects of counselor-delivered Prolonged Exposure therapy compared with supportive counseling for adolescents with PTSD. Design, Setting, and Participants A single-blind, randomized clinical trial of 61 adolescent girls with PTSD using a permuted block design. Counselors previously naive to Prolonged Exposure therapy provided the treatments in a community mental health clinic. Data collection lasted from February 2006 through March 2012. Interventions Participants received fourteen 60- to 90-minute sessions of Prolonged Exposure therapy (n = 31) or supportive counseling (n = 30). Main Outcomes and Measures All outcomes were assessed before treatment, at mid-treatment, and after treatment and at 3-, 6-, and 12-month follow-up. The primary outcome, PTSD symptom severity, was assessed by the Child PTSD Symptom Scale–Interview (range, 0-51; higher scores indicate greater severity). Secondary outcomes were presence or absence of PTSD diagnosis assessed by the DSM-IV Schedule for Affective Disorders and Schizophrenia for School-Age Children and functioning assessed by the Children’s Global Assessment Scale (range, 1-100; higher scores indicate better functioning). Additional secondary measures, PTSD severity assessed by the Child PTSD Symptom Scale–Self-Report (range, 0-51; higher scores indicate greater severity) and depression severity assessed by the Children’s Depression Inventory (range, 0-54; higher scores indicate greater severity), were also assessed weekly during treatment. Results Data were analyzed as intent to treat. During treatment, participants receiving Prolonged Exposure demonstrated greater improvement on the PTSD symptom severity scale (difference between treatments in improvement, 7.5; 95% CI, 2.5-12.5; P P = .01; self-reported PTSD severity: difference, 6.2; 95% CI, 1.2-11.2; P = .02; depression: difference, 4.9; 95% CI, 1.6-8.2; P = .008; global functioning: difference, 10.1; 95% CI, 3.4-16.8; P = .008). These treatment differences were maintained through the 12-month follow-up: for interviewer-assessed PTSD (difference, 6.0; 95% CI, 1.6-10.4; P = . 02), loss of PTSD diagnosis (difference, 31.1; 95% CI, 14.7-34.8; P = .01), self-reported PTSD (difference, 9.3; 95% CI, 1.2-16.5; P = .02), depression (difference, 7.2; 95% CI, 1.4-13.0; P = .02), and global functioning (difference, 11.2; 95% CI, 4.5-17.9; P = .01). Conclusion and Relevance Adolescents girls with sexual abuse–related PTSD experienced greater benefit from Prolonged Exposure therapy than from supportive counseling even when delivered by counselors who typically provide supportive counseling. Trial Registration clinicaltrials.gov Identifier:NCT00417300
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dissemination and implementation of Prolonged Exposure therapy for posttraumatic stress disorder
Journal of Anxiety Disorders, 2013Co-Authors: Carmen P McleanAbstract:Abstract Posttraumatic stress disorder (PTSD) is a highly prevalent, often chronic and disabling psychiatric disorder that is associated with significant adverse health and life consequences. Although several evidence-based treatments (EBTs), including Prolonged Exposure therapy (PE), have been found effective and efficacious in reducing PTSD symptomology, the majority of individuals with this disorder receive treatments of unknown efficacy. Thus, it is imperative that EBTs such as PE be made available to PTSD sufferers through widespread dissemination and implementation. We will review some of the efforts to increase the availability of PE and the common barriers to successful dissemination and implementation. We also discuss novel dissemination strategies that are harnessing technology to overcome barriers to dissemination.
Barbara O Rothbaum - One of the best experts on this subject based on the ideXlab platform.
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efficacy of Prolonged Exposure therapy sertraline hydrochloride and their combination among combat veterans with posttraumatic stress disorder a randomized clinical trial
JAMA Psychiatry, 2019Co-Authors: Sheila A. M. Rauch, Sonya B. Norman, Corey Powell, Peter W Tuerk, Naomi M Simon, Ron Acierno, Carolyn B Allard, Margaret R Venners, Barbara O RothbaumAbstract:Importance Meta-analyses of treatments for posttraumatic stress disorder (PTSD) suggest that trauma-focused psychotherapies produce greater benefits than antidepressant medications alone. Objective To determine the relative efficacy of Prolonged Exposure therapy plus placebo, Prolonged Exposure therapy plus sertraline hydrochloride, and sertraline plus enhanced medication management in the treatment of PTSD. Design, Setting, and Participants The Prolonged Exposure and Sertraline Trial was a randomized, multisite, 24-week clinical trial conducted at the Veterans Affairs Ann Arbor Healthcare System, Veterans Affairs San Diego Healthcare System, Ralph H. Johnson Veterans Affairs Medical Center, and Massachusetts General Hospital Home Base Veterans Program between January 26, 2012, and May 9, 2016. Participants and clinicians were blinded to pill condition, and outcome evaluators were blinded to assignment. Participants completed assessments at weeks 0 (intake), 6, 12, 24, and 52 (follow-up). Participants (N = 223) were service members or veterans of the Iraq and/or Afghanistan wars with combat-related PTSD and significant impairment (Clinician-Administered PTSD Scale score, ≥50) of at least 3 months’ duration. Analyses were on an intent-to-treat basis. Intervention Participants completed up to thirteen 90-minute sessions of Prolonged Exposure therapy by week 24. Sertraline dosage was titrated during a 10-week period and continued until week 24; medication management was manualized. Main Outcomes and Measures The primary outcome was symptom severity of PTSD in the past month as assessed by the Clinician-Administered PTSD Scale score at week 24. Results Of 223 randomized participants, 149 completed the study at 24 weeks, and 207 (180 men and 27 women; mean [SD] age, 34.5 [8.3 years]) were included in the intent-to-treat analysis. Modified intent-to-treat analysis using a mixed model of repeated measures showed that PTSD symptoms decreased significantly during the 24 weeks (sertraline plus enhanced medication management, 33.8 points; Prolonged Exposure therapy plus sertraline, 32.7 points; and Prolonged Exposure therapy plus placebo, 29.4 points; β,–9.39; 95% CI, −11.62 to −7.16;P Conclusions and Relevance No difference in change in PTSD symptoms or symptom severity at 24 weeks was found between sertraline plus enhanced medication management, Prolonged Exposure therapy plus placebo, and Prolonged Exposure therapy plus sertraline. Trial Registration ClinicalTrials.gov Identifier:NCT01524133
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augmentation of sertraline with Prolonged Exposure in the treatment of posttraumatic stress disorder
Journal of Traumatic Stress, 2006Co-Authors: Barbara O Rothbaum, Millie C Astin, Shawn P Cahill, Jonathan R T Davidson, Jill S Compton, Kathryn M Connor, Changgyu HahnAbstract:The present study was designed to determine whether augmenting sertraline with Prolonged Exposure (PE) would result in greater improvement than continuation with sertraline alone. Outpatient men and women with chronic PTSD completed 10 weeks of open label sertraline and then were randomly assigned to five additional weeks of sertraline alone (n = 31) or sertraline plus 10 sessions of twice-weekly PE (n = 34). Results indicated that sertraline led to a significant reduction in PTSD severity after 10 weeks but was associated with no further reductions after five more weeks. Participants who received PE showed further reduction in PTSD severity. This augmentation effect was observed only for participants who showed a partial response to medication.
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Prolonged Exposure versus eye movement desensitization and reprocessing emdr for ptsd rape victims
Journal of Traumatic Stress, 2005Co-Authors: Barbara O Rothbaum, Millie C Astin, Fred MarstellerAbstract:This controlled study evaluated the relative efficacy of Prolonged Exposure (PE) and Eye Movement Desensitization and Reprocessing (EMDR) compared to a no-treatment waitlist control (WAIT) in the treatment of PTSD in adult female rape victims (n = 74). Improvement in PTSD as assessed by blind independent assessors, depression, dissociation, and state anxiety was significantly greater in both the PE and EMDR group than the WAIT group (n = 20 completers per group). PE and EMDR did not differ significantly for change from baseline to either posttreatment or 6-month follow-up measurement for any quantitative scale.
Sheila A. M. Rauch - One of the best experts on this subject based on the ideXlab platform.
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Prolonged Exposure Therapy for PTSD - Foundations of Prolonged Exposure
Prolonged Exposure Therapy for PTSD, 2020Co-Authors: Elizabeth A. Hembree, Barbara Olasov Rothbaum, Sheila A. M. RauchAbstract:Foundations of Prolonged Exposure (PE) include (1) education about common reactions to trauma, what maintains trauma-related symptoms, and how PE reduces posttraumatic stress disorder (PTSD) symptoms; (2) repeated in vivo confrontation with situations, people, or objects that the patient is avoiding because they are trauma-related and cause emotional distress such as anxiety, shame, or guilt; and (3) repeated, Prolonged imaginal Exposure to the trauma memories followed by processing the details of the event, the emotions, and the thoughts that the patient experienced during the trauma. The aim of in vivo and imaginal Exposure is to enhance emotional processing of traumatic events by helping the patient face the trauma memories and reminders and process the emotions and thoughts, as well as the details of the trauma that emerge during revisiting experiences.
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Prolonged Exposure for PTSD: Impact on emotions
Emotion in Posttraumatic Stress Disorder, 2020Co-Authors: Katie A. Ragsdale, Lauren B. Mcsweeney, Sheila A. M. RauchAbstract:Abstract Prolonged Exposure (PE) is an empirically supported treatment for posttraumatic stress disorder (PTSD) that has reliably established clinically significant reduction of symptoms. In this chapter, we present an overview of PE and its efficacy, review the emotional processing theory (EPT) to explain the etiology and treatment of PTSD, and examine the influence of PE on specific emotions. While PE has long been understood to effectively target fear and anxiety, we present research that supports PE’s effectiveness at ameliorating diverse trauma sequelae, including anger, guilt, sadness, and even emotion dysregulation. We discuss how PE may modify these different emotional reactions, including through emotional activation and modification of unhelpful cognitions. We present a case study of treating diverse emotions within the context of PE and explore how culture may impact PE. Additional research into how PE modifies specific emotions is warranted. Directions for future research include continuing to study PE mechanisms of action including elucidation of specific mechanisms that modify diverse emotions.
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efficacy of Prolonged Exposure therapy sertraline hydrochloride and their combination among combat veterans with posttraumatic stress disorder a randomized clinical trial
JAMA Psychiatry, 2019Co-Authors: Sheila A. M. Rauch, Sonya B. Norman, Corey Powell, Peter W Tuerk, Naomi M Simon, Ron Acierno, Carolyn B Allard, Margaret R Venners, Barbara O RothbaumAbstract:Importance Meta-analyses of treatments for posttraumatic stress disorder (PTSD) suggest that trauma-focused psychotherapies produce greater benefits than antidepressant medications alone. Objective To determine the relative efficacy of Prolonged Exposure therapy plus placebo, Prolonged Exposure therapy plus sertraline hydrochloride, and sertraline plus enhanced medication management in the treatment of PTSD. Design, Setting, and Participants The Prolonged Exposure and Sertraline Trial was a randomized, multisite, 24-week clinical trial conducted at the Veterans Affairs Ann Arbor Healthcare System, Veterans Affairs San Diego Healthcare System, Ralph H. Johnson Veterans Affairs Medical Center, and Massachusetts General Hospital Home Base Veterans Program between January 26, 2012, and May 9, 2016. Participants and clinicians were blinded to pill condition, and outcome evaluators were blinded to assignment. Participants completed assessments at weeks 0 (intake), 6, 12, 24, and 52 (follow-up). Participants (N = 223) were service members or veterans of the Iraq and/or Afghanistan wars with combat-related PTSD and significant impairment (Clinician-Administered PTSD Scale score, ≥50) of at least 3 months’ duration. Analyses were on an intent-to-treat basis. Intervention Participants completed up to thirteen 90-minute sessions of Prolonged Exposure therapy by week 24. Sertraline dosage was titrated during a 10-week period and continued until week 24; medication management was manualized. Main Outcomes and Measures The primary outcome was symptom severity of PTSD in the past month as assessed by the Clinician-Administered PTSD Scale score at week 24. Results Of 223 randomized participants, 149 completed the study at 24 weeks, and 207 (180 men and 27 women; mean [SD] age, 34.5 [8.3 years]) were included in the intent-to-treat analysis. Modified intent-to-treat analysis using a mixed model of repeated measures showed that PTSD symptoms decreased significantly during the 24 weeks (sertraline plus enhanced medication management, 33.8 points; Prolonged Exposure therapy plus sertraline, 32.7 points; and Prolonged Exposure therapy plus placebo, 29.4 points; β,–9.39; 95% CI, −11.62 to −7.16;P Conclusions and Relevance No difference in change in PTSD symptoms or symptom severity at 24 weeks was found between sertraline plus enhanced medication management, Prolonged Exposure therapy plus placebo, and Prolonged Exposure therapy plus sertraline. Trial Registration ClinicalTrials.gov Identifier:NCT01524133
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Prolonged Exposure for ptsd in a veterans health administration ptsd clinic
Journal of Traumatic Stress, 2009Co-Authors: Sheila A. M. Rauch, Erin Defever, Todd Favorite, Anne Duroe, Cecily Garrity, Brian Martis, Israel LiberzonAbstract:With the move toward dissemination of empirically supported treatments in the Veterans Health Administration (VHA), dissemination of additional data concerning the effectiveness of Prolonged Exposure (PE) among veterans is important. The authors present clinical treatment data from veterans with chronic posttraumatic stress disorder (PTSD) treated in a VHA PTSD clinic (N = 10). Veterans demonstrated significant reductions in total PTSD symptoms from pre- to posttreatment. Returning veterans from the conflicts in Afghanistan and Iraq and other era veterans (Vietnam Veterans and military sexual trauma veterans) demonstrated significant reductions in PTSD. In addition, veterans demonstrated significant reductions in depression from pre- to posttreatment. In conclusion, PE is effective in reducing the symptoms of PTSD in veterans.
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cognitive changes during Prolonged Exposure versus Prolonged Exposure plus cognitive restructuring in female assault survivors with posttraumatic stress disorder
Journal of Consulting and Clinical Psychology, 2004Co-Authors: Sheila A. M. RauchAbstract:The authors report on changes in cognitions related to posttraumatic stress disorder (PTSD) among 54 female survivors of sexual and nonsexual assault with chronic PTSD who completed either Prolonged Exposure alone or in combination with cognitive restructuring. Treatment included 9-12 weekly sessions, and assessment was conducted at pretreatment, posttreatment, and a modal 12-month follow-up. As hypothesized, treatment that included Prolonged Exposure resulted in clinically significant, reliable, and lasting reductions in negative cognitions about self, world, and self-blame as measured by the Posttraumatic Cognitions Inventory. The hypothesis that the addition of cognitive restructuring would augment cognitive changes was not supported. Reductions in these negative cognitions were significantly related to reductions in PTSD symptoms. The addition of cognitive restructuring did not significantly augment the cognitive changes. Theoretical implications of the results are discussed. Language: en
Lori A Zoellner - One of the best experts on this subject based on the ideXlab platform.
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doubly randomized preference trial of Prolonged Exposure versus sertraline for treatment of ptsd
American Journal of Psychiatry, 2019Co-Authors: Lori A Zoellner, Matig Mavissakalian, Peter Roybyrne, Norah C FeenyAbstract:Objective:The authors examined the effect of patient treatment preference on the differential effectiveness of Prolonged Exposure and sertraline for the treatment of posttraumatic stress disorder (...
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cost effectiveness of Prolonged Exposure therapy versus pharmacotherapy and treatment choice in posttraumatic stress disorder the optimizing ptsd treatment trial a doubly randomized preference trial
The Journal of Clinical Psychiatry, 2014Co-Authors: Quang A Le, Lori A Zoellner, Jason N Doctor, Norah C FeenyAbstract:OBJECTIVE: Cost-effectiveness of treatment for posttraumatic stress disorder (PTSD) may depend on type of treatment (eg, pharmacotherapy vs psychotherapy) and patient choice of treatment. We examined the cost-effectiveness of treatment with Prolonged Exposure therapy versus pharmacotherapy with sertraline, overall treatment preference, preference for choosing Prolonged Exposure therapy, and preference for choosing pharmacotherapy with sertraline from the US societal perspective. METHOD: Two hundred patients aged 18 to 65 years with PTSD diagnosis based on DSM-IV criteria enrolled in a doubly randomized preference trial. Patients were randomized to receive their treatment of choice (n = 97) or to be randomly assigned treatment (n = 103). In the choice arm, patients chose either Prolonged Exposure therapy (n = 61) or pharmacotherapy with sertraline (n = 36). In the no-choice arm, patients were randomized to either Prolonged Exposure therapy (n = 48) or pharmacotherapy with sertraline (n = 55). The total costs, including direct medical costs, direct nonmedical costs, and indirect costs, were estimated in 2012 US dollars; and total quality-adjusted life-year (QALY) was assessed using the EuroQoL Questionnaire-5 dimensions (EQ-5D) instrument in a 12-month period. This study was conducted from July 2004 to January 2009. RESULTS: Relative to pharmacotherapy with sertraline, Prolonged Exposure therapy was less costly (-$262; 95% CI, -$5,068 to $4,946) and produced more QALYs (0.056; 95% CI, 0.014 to 0.100) when treatment was assigned, with 93.2% probability of being cost-effective at $100,000/QALY. Independently, giving a choice of treatment also yielded lower cost (-$1,826; 95% CI, -$4,634 to $749) and more QALYs (0.010; 95% CI, -0.019 to 0.044) over no choice of treatment, with 87.0% probability of cost-effectiveness at $100,000/QALY. CONCLUSIONS: Giving PTSD patients a choice of treatment appears to be cost-effective. When choice is not possible, Prolonged Exposure therapy may provide a cost-effective option over pharmacotherapy with sertraline. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00127673.
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Sudden gains in Prolonged Exposure and sertraline for chronic PTSD.
Depression and Anxiety, 2013Co-Authors: Lori A Zoellner, Norah C FeenyAbstract:Background Sudden gains are significant, rapid improvements in symptoms, larger than typical between-session symptom reduction.[8] Sudden gains in a large sample of individuals with PTSD have not been studied, and only one study has looked at it in pharmacotherapy, but not in PTSD. In the present study, we examined the occurrence of sudden gains in psychotherapy, specifically Prolonged Exposure (PE), and pharmacotherapy, specifically sertraline, for chronic PTSD.
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examining potential contraindications for Prolonged Exposure therapy for ptsd
European Journal of Psychotraumatology, 2012Co-Authors: Agnes Van Minnen, Lori A Zoellner, Melanie S Harned, Katherine L MillsAbstract:Although Prolonged Exposure (PE) has received the most empirical support of any treatment for posttraumatic stress disorder (PTSD), clinicians are often hesitant to use PE due to beliefs that it is contraindicated for many patients with PTSD. This is especially true for PTSD patients with comorbid problems. Because PTSD has high rates of comorbidity, it is important to consider whether PE is indeed contraindicated for patients with various comorbid problems. Therefore, in this study, we examine the evidence for or against the use of PE with patients with problems that often co-occur with PTSD, including dissociation, borderline personality disorder, psychosis, suicidal behavior and non-suicidal self-injury, substance use disorders, and major depression. It is concluded that PE can be safely and effectively used with patients with these comorbidities, and is often associated with a decrease in PTSD as well as the comorbid problem. In cases with severe comorbidity, however, it is recommended to treat PTSD with PE while providing integrated or concurrent treatment to monitor and address the comorbid problems. Keywords: PTSD; comorbidity; Prolonged Exposure; (contra)indications For the abstract or full text in other languages, please see Supplementary files under Reading Tools online (Published: 25 July 2012) Citation: European Journal of Psychotraumatology 2012, 3 : 18805 - http://dx.doi.org/10.3402/ejpt.v3i0.18805
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Do You Need To Talk About It? Prolonged Exposure for the Treatment of Chronic PTSD.
The behavior analyst today, 2006Co-Authors: Afsoon Eftekhari, Lisa R. Stines, Lori A ZoellnerAbstract:Is addressing the traumatic memory a necessary component of the treatment of posttraumatic stress disorder (PTSD)? Perhaps not for everyone, but in the present paper, we suggest that Prolonged Exposure, a cognitive behavioral treatment that includes repeated recounting of the traumatic memory, is a viable and robust treatment option. Prolonged Exposure (PE) is widely regarded as an efficacious treatment for chronic posttraumatic stress disorder (Foa, Keane, & Friedman, 2000). The present paper reviews the efficacy and effectiveness of PE for the treatment of chronic PTSD and for a broader range of trauma-related symptoms. We will also review issues surrounding the acceptability of PE to mental health providers and potential clients. We conclude with a discussion the need for dissemination, additional dismantling studies, and further cross-cultural research.
