A randomized clinical trial of group cognitive processing therapy compared with group present-centered therapy for PTSD among active duty military personnel.

To determine whether group therapy improves symptoms of posttraumatic stress disorder (PTSD), this randomized clinical trial compared efficacy of group cognitive processing therapy (cognitive only version; CPT-C) with group present-centered therapy (PCT) for active duty military personnel. Patients attended 90-min groups twice weekly for 6 weeks at Fort Hood, Texas. Independent assessments were administered at baseline, weekly before sessions, and 2 weeks, 6 months, and 12 months posttreatment. A total of 108 service members (100 men, 8 women) were randomized. Inclusion criteria included PTSD following military deployment and medication stability. Exclusion criteria included suicidal/homicidal intent or other severe mental disorders requiring immediate treatment. Follow-up assessments were administered regardless of treatment completion. Primary outcome measures were the PTSD Checklist (Stressor Specific Version; PCL-S) and Beck Depression Inventory-II. The Posttraumatic Stress Symptom Interview (PSS-1) was a secondary measure. Both treatments resulted in large reductions in PTSD severity, but improvement was greater in CPT-C. CPT-C also reduced depression, with gains remaining during follow-up. In PCT, depression only improved between baseline and before Session 1. There were few adverse events associated with either treatment. Both CPT-C and PCT were tolerated well and reduced PTSD symptoms in group format, but only CPT-C improved depression. This study has public policy implications because of the number of active military needing PTSD treatment, and demonstrates that group format of treatment of PTSD results in significant improvement and is well tolerated. Group therapy may an important format in settings in which therapists are limited.

Resick PA ，Wachen JS ，Mintz J ，Young-McCaughan S ，Roache JD ，Borah AM ，Borah EV ，Dondanville KA ，Hembree EA ，Litz BT ，Peterson AL ... -  《-》

Effect of Group vs Individual Cognitive Processing Therapy in Active-Duty Military Seeking Treatment for Posttraumatic Stress Disorder: A Randomized Clinical Trial.

Resick PA ，Wachen JS ，Dondanville KA ，Pruiksma KE ，Yarvis JS ，Peterson AL ，Mintz J ，and the STRONG STAR Consortium ，Borah EV ，Brundige A ，Hembree EA ，Litz BT ，Roache JD ，Young-McCaughan S ... -  《-》

EVALUATING POTENTIAL IATROGENIC SUICIDE RISK IN TRAUMA-FOCUSED GROUP COGNITIVE BEHAVIORAL THERAPY FOR THE TREATMENT OF PTSD IN ACTIVE DUTY MILITARY PERSONNEL.

To determine whether group cognitive processing therapy-cognitive only version (CPT-C) is associated with iatrogenic suicide risk in a sample of active duty US Army personnel diagnosed with posttraumatic stress disorder (PTSD). Possible iatrogenic effects considered include the incidence and severity of suicide ideation, worsening of preexisting suicide ideation, incidence of new-onset suicide ideation, and incidence of suicide attempts among soldiers receiving group CPT-C. Comparison with group present-centered therapy (PCT) was made to contextualize findings. One hundred eight soldiers (100 men, eight women) diagnosed with PTSD were randomized to receive either group CPT-C or group PCT. PTSD diagnosis was confirmed via structured clinician interview. Suicide ideation, depression severity, and PTSD severity were assessed at pretreatment, weekly during treatment, and 2 weeks, 6 months, and 12 months posttreatment. Rates of suicide ideation significantly decreased across both treatments. Among soldiers with pretreatment suicide ideation, severity of suicide ideation significantly decreased across both treatments and was maintained for up to 12 months posttreatment. Exacerbation of preexisting suicide ideation was uncommon in both treatments. New-onset suicide ideation was rare and similar across both treatments (<16%). There were no suicide attempts during treatment or follow-up in either group. Change in depression symptoms predicted change in suicide risk. Suicide-related outcomes were similar across both treatments and primarily associated with comorbid depression. Suicide-related outcomes in group CPT-C were rare and comparable to patterns observed in an active, nontrauma-focused therapy, even among soldiers who entered treatment with suicide ideation. NCT01286415, https://clinicaltrials.gov/ct2/show/NCT01286415.

Bryan CJ ，Clemans TA ，Hernandez AM ，Mintz J ，Peterson AL ，Yarvis JS ，Resick PA ，STRONG STAR Consortium ... -  《-》

Effect of Prolonged Exposure Therapy Delivered Over 2 Weeks vs 8 Weeks vs Present-Centered Therapy on PTSD Symptom Severity in Military Personnel: A Randomized Clinical Trial.

Foa EB ，McLean CP ，Zang Y ，Rosenfield D ，Yadin E ，Yarvis JS ，Mintz J ，Young-McCaughan S ，Borah EV ，Dondanville KA ，Fina BA ，Hall-Clark BN ，Lichner T ，Litz BT ，Roache J ，Wright EC ，Peterson AL ，STRONG STAR Consortium ... -  《-》

Cognitive processing therapy for male veterans with military sexual trauma-related posttraumatic stress disorder.

The current study examined 11 male veterans with military sexual trauma (MST)-related posttraumatic stress disorder (PTSD) who participated in a larger randomized control trial comparing cognitive processing therapy (CPT) to a well-established control treatment (Present Centered Therapy; PCT) among men and women with MST-related PTSD. All participants (n=11) completed a 12 session protocol of CPT. The Clinician Administered PTSD Scale (CAPS), PTSD Checklist (PCL), and Quick Inventory of Depressive Symptomatology (QIDS) were administered at baseline and post-treatment sessions 2, 4, and 6 months after CPT completion. Additionally, the PCL and QIDS were administered every two sessions during CPT treatment. Piecewise growth curve analyses revealed that significant change over time in both PTSD and depressive symptoms was associated with the active treatment phase and that participants maintained treatment gains over the 6-month follow-up period. CPT effectively reduced self-reported symptoms of PTSD as well as depressive symptoms for men with MST-related PTSD. Additionally, participants maintained the gains they made during treatment over a 6-month follow-up period. It is recommended that future studies examine patient characteristics that might impact outcome in order to improve understanding of who benefits the most from treatment.

Mullen K ，Holliday R ，Morris E ，Raja A ，Surís A ... -  《-》