Greater PTSD Improvement From Massed Prolong Exposure vs Minimal Contact Therapy

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older woman talking to man
Prolonged exposure therapy was associated with a greater reduction in PTSD symptom severity compared with a minimal-contact control.

HealthDay News — Prolonged exposure therapy administered as mass therapy was associated with a greater reduction in posttraumatic stress disorder (PTSD) symptom severity than a minimal-contact control (MCC), according to a study published in the Journal of the American Medical Association.

Edna B. Foa, PhD, from the University of Pennsylvania in Philadelphia, and colleagues conducted a randomized trial involving 370 military personnel with PTSD who had returned from Iraq, Afghanistan, or both. Participants were assigned to receive prolonged exposure therapy (cognitive behavior therapy involving exposure to trauma memories/reminders, administered as massed therapy [10 sessions over two weeks] or spaced therapy [10 sessions over eight weeks]; 110 and 109 participants, respectively); present-centered therapy (PCT; non-trauma focused therapy involving identifying/discussing daily stressors; 107 participants); or MCC (telephone calls from therapists; 40 participants)

The researchers found that at 2 weeks after treatment, the mean PTSD Symptom Scale-Interview (PSS-I) score was 17.62 for massed therapy (mean decrease from baseline, 7.13) and 21.41 for MCC (mean decrease, 3.43; difference in decrease, 3.7; 95% CI, 0.72-6.68). The mean PSS-I score was 18.03 for spaced therapy (decrease, 7.29; difference vs massed therapy, 0.79). At 12 weeks after treatment, the mean PSS-I score was 18.88 for massed therapy (decrease, 6.32) and 18.34 for spaced therapy (decrease, 6.97; difference, 0.55). The PSS-I scores for PCT were 18.65 (decrease, 7.31; difference in decrease vs spaced therapy, 0.1 [95% CI, −2.48- 2.27]) at post-treatment.

“The reductions in PTSD symptom severity with all treatments were relatively modest, suggesting that further research is needed to determine the clinical importance of these findings,” the authors wrote.

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Foa EB, McLean CP, Zang Y, et al. 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. JAMA. 2018;319(4):354-364