Predictors of attendance and dropout in three randomized controlled trials of PTSD treatment for active duty service members

STRONG STAR Consortium

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Dropout from first-line posttraumatic stress disorder (PTSD) treatments is a significant problem. We reported rates and predictors of attendance and dropout in three clinical trials of evidence-based PTSD treatments in military service members (N = 557). Service members attended 81.0% of treatment sessions and 30.7% dropped out. Individually delivered treatment was associated with greater attendance rates (β = 0.23, p <.001) than group therapy; trauma-focused treatments were associated with higher dropout (β = 0.19, p <.001) than Present-Centered Therapy. Age was a significant predictor of session attendance (β = 0.17, p <.001) and drop out (β = −0.23, p <.001). History of traumatic brain injury (TBI) predicted lower attendance rates (β = −0.26, p <.001) and greater dropout (β = 0.19, p <.001). Regardless of treatment type or format, patients who did not drop out were more likely to experience clinically significant gains (d = 0.49, p <.001). Results demonstrate that dropout from PTSD treatments in these trials was significantly associated with treatment outcome and suggest that strategies are needed to mitigate dropout, particularly in group and trauma-focused therapies, and among younger service members and those with TBI.

Original languageEnglish (US)
Pages (from-to)7-17
Number of pages11
JournalBehaviour Research and Therapy
Volume118
DOIs
StatePublished - Jul 2019

Keywords

  • Active duty service members
  • Attendance
  • Clinical trial
  • Dropout
  • PTSD

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Clinical Psychology
  • Psychiatry and Mental health

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