A Randomized Clinical Trial of Cognitive-Behavioral Treatment for Post-Traumatic Stress Disorders in Women
The purpose of the proposed DVA cooperative study is to evaluate the efficacy of exposure therapy for treating PTSD and associated problems in female veterans and active duty military personnel. We propose to compare exposure therapy, Prolonged Exposure, with a comparison therapy that focuses on current problems, Present Centered Therapy.
The study is a randomized clinical trial involving 384 female veterans and active duty personnel in 11 VA medical centers and 1 DoD medical center. All subjects, even self-referrals, will enter the study through referrals by mental health clinicians at the participating sites. Following informed consent, subjects will be screened for inclusion and exclusion diagnoses. If they meet these criteria and agree to participate, they will be randomly assigned to one of the two treatments, which will occur weekly for 10 weeks. Subjects will be assessed before treatment, immediately following treatment, and 3 and 6 months after the end of treatment. The primary outcome is PTSD severity. Secondary outcomes are anxiety and depression. Exploratory outcomes include associated features of PTSD, such as dissociation and substance abuse; psychosocial functioning, quality of life, physical health, satisfaction with treatment, and service utilization. Both treatments will be described in detail in a treatment manual and monitored intensively to ensure that they are administered correctly.
|Stress Disorders, Post-Traumatic||Procedure: Prolonged Exposure Procedure: Present Centered Therapy||Phase 3|
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Investigator)
Primary Purpose: Treatment
|Official Title:||CSP #494 - A Randomized Clinical Trial of Cognitive-Behavioral Treatment for PTSD in Women (PTSD)|
- summing totals of 17 DSM-IV symptoms [ Time Frame: 10 weeks ]
|Study Start Date:||August 2002|
|Study Completion Date:||April 2006|
|Primary Completion Date:||April 2006 (Final data collection date for primary outcome measure)|
Active Comparator: 1
Procedure: Prolonged Exposure
trauma-focused exposure therapy
Active Comparator: 2
Present Centered Therapy
Procedure: Present Centered Therapy
therapy that focuses on current problems
Intervention: Patients will be randomized to one of two interventions: Prolonged Exposure (PE) consisting of 10 weekly treatment sessions that include education about and exposure to the memories of the trauma to which the patient was engaged; or Present Center Therapy (PCT), which will consist of a control therapy of the same duration that will provide emotional support for the trauma victim.
Primary Hypothesis: Prolonged Exposure (PE) will be more effective than Present-Centered Therapy (PCT) for the treatment of PTSD due to military-related trauma in women veterans. PE specifically targets PTSD symptoms, and the CAPS, our primary outcome measure. The Clinician Administered PTSD Scale (CAPS) is considered to be the gold-standard for PTSD assessment.
Secondary Hypothesis: PE will be more effective than PCT for treating the anxiety and depression that often are comorbid with PTSD.
Study Abstract: As noted in a recent report on the VA Women's Health Project, it is important to study women veterans because they are increasingly seeking VA health care. For many women veterans, Posttraumatic Stress Disorder (PTSD) is a specific healthcare concern that is associated with substantial psychosocial and functional disability.
The study was proposed in response to the Research Priority Announcement on Posttraumatic Stress Disorder research issued August 1, 1997, as a study aimed a special subpopulation of VA patients with PTSD: women veterans who have been traumatized during their military service.
The first planning meeting for the study was held January 20-21, 2000 in Washington, DC. The protocol was submitted on August 1, 2000; it was reviewed and approved by the Cooperative Studies Evaluation Committee on October 10, 2000. Intake of training cases is expected to begin 01/01/2002.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00032617
|United States, Colorado|
|VA Eastern Colorado Health Care System, Denver|
|Denver, Colorado, United States, 80220|
|United States, Florida|
|VA Medical Center, Bay Pines|
|Bay Pines, Florida, United States, 33708|
|United States, Georgia|
|Atlanta VA Medical and Rehab Center, Decatur|
|Decatur, Georgia, United States, 30033|
|United States, Louisiana|
|Southeast Veterans Healthcare System, New Orleans|
|New Orleans, Louisiana, United States, 70112|
|United States, Maryland|
|VA Maryland Health Care System, Baltimore|
|Baltimore, Maryland, United States, 21201|
|Walter Reed (DCI-HUC)|
|Bethesda, Maryland, United States, 20814|
|United States, Massachusetts|
|VA Medical Center, Jamaica Plain Campus|
|Boston, Massachusetts, United States, 02130|
|United States, New Mexico|
|New Mexico VA Health Care System, Albuquerque|
|Albuquerque, New Mexico, United States, 87108-5153|
|United States, Ohio|
|VA Medical Center, Cincinnati|
|Cincinnati, Ohio, United States, 45220|
|VA Medical Center, Cleveland|
|Cleveland, Ohio, United States, 44106|
|United States, Oregon|
|VA Medical Center, Portland|
|Portland, Oregon, United States, 97201|
|United States, Texas|
|VA North Texas Health Care System, Dallas|
|Dallas, Texas, United States, 75216|
|United States, Vermont|
|VA Medical & Regional Office Center|
|White River Junction, Vermont, United States, 05009-0001|
|Study Chair:||Matthew J. Friedman, MD PhD||VA Medical & Regional Office Center|