Patterns and Predictors of Change in Trauma-Focused Treatments for War-Related Posttraumatic Stress Disorder

Brett T. Litz, Danielle S. Berke, Kevin Grimm, Patricia A. Resick, Jennifer S. Wachen, Katherine A. Dondanville, John D. Roache, Stacey Young-McCaughan, Jim Mintz, Nora K. Kline, Luke Rusowicz-Orazem, Edna B. Foa, Carmen P. McLean, Adam M. Borah, Jeffrey S. Yarvis, Alan L. Peterson

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Objective: We evaluated patterns and predictors of change from three efficacy trials of trauma-focused cognitive–behavioral treatments (TF-CBT) among service members (N = 702; mean age = 32.88; 89.4% male; 79.8% non-Hispanic/Latino). Rates of clinically significant change were also compared with other trials. Method: The trials were conducted in the same setting with identical measures. The primary outcome was symptom severity scores on the PTSD Symptom Scale—Interview Version (PSS-I; Foa, Riggs, Dancu, & Rothbaum, 1993). Results: Symptom change was best explained by baseline scores and individual slopes. TF-CBT was not associated with better slope change relative to Present-Centered Therapy, a comparison arm in 2 trials. Lower baseline scores (β = .33, p < .01) and higher ratings of treatment credibility (β = − .22, p < .01) and expectancy for change (β = − .16, p < .01) were associated with greater symptom change. Older service members also responded less well to treatment (β = .09, p < .05). Based on the Jacobson and Truax (1991) metric for clinically significant change, 31% of trial participants either recovered or improved. Conclusions: Clinicians should individually tailor treatment for service members with high baseline symptoms, older patients, and those with low levels of credibility and expectancy for change.

Original languageEnglish (US)
Pages (from-to)1019-1029
Number of pages11
JournalJournal of consulting and clinical psychology
Volume87
Issue number11
DOIs
StatePublished - 2019

Keywords

  • Active duty military
  • Posttraumatic stress disorder
  • War-related PTSD

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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