Behavioral Activation for PTSD/Depression Treatment in OIF/OEF Veterans
| Status: | Completed |
|---|---|
| Conditions: | Depression, Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 11/7/2018 |
| Start Date: | May 2009 |
| End Date: | July 2013 |
Behavioral Activation for PTSD, Depression Treatment in OIF/OEF Veterans
The present study is a randomized, controlled trial that compares Behavioral Activation (BA)
to Treatment As Usual (TAU) in PTSD Specialty clinics, as early psychotherapeutic
interventions for OIF/OEF veterans with posttraumatic stress disorder (PTSD).
to Treatment As Usual (TAU) in PTSD Specialty clinics, as early psychotherapeutic
interventions for OIF/OEF veterans with posttraumatic stress disorder (PTSD).
A sizable proportion of soldiers involved in the Iraq and Afghanistan conflicts are
experiencing mental health and adjustment problems on their return, including posttraumatic
stress disorder and depression (Hoge et al., 2004). Both PTSD and depression can be chronic
and debilitating disorders, associated with impairments in social, occupational, and physical
functioning, as well as high health care utilization (Katon, Unutzer, & Simon, 2004; Stein et
al., 2005).
Although empirically supported treatments exist for established PTSD and depression, much
less is known about effective early interventions for these conditions. Exploration of early
intervention options is necessary, particularly in the case of the new veteran population, as
such interventions could address social, occupational and physical impairments before they
become too intractable. Also, successful early interventions could curtail high health care
utilization dramatically across time. The development of such early interventions for PTSD
and depression must also take into account any specifications of accessibility and
acceptability that are particular to the OIF/OEF veteran population.
The present study is a randomized, controlled trial that compares Behavioral Activation (BA),
to Treatment As Usual (TAU) as early interventions for OIF/OEF veterans with posttraumatic
stress disorder (PTSD). Participants will be recruited largely from the primary health care
setting (to increase acceptability and accessibility to the veteran population). Both BA and
TAU treatment groups will be administered by psychotherapists who specialize in the treatment
of PTSD. Both groups will be assessed at pre-, mid- and post-treatment time points to
determine change over time, health care utilization and treatment satisfaction. This is a
dual-site study that will be carried out at both the Portland VA Medical Center (PVAMC) and
the VA Puget Sound Health Care Center (VA PSHCS) and coordinated at the PVAMC.
experiencing mental health and adjustment problems on their return, including posttraumatic
stress disorder and depression (Hoge et al., 2004). Both PTSD and depression can be chronic
and debilitating disorders, associated with impairments in social, occupational, and physical
functioning, as well as high health care utilization (Katon, Unutzer, & Simon, 2004; Stein et
al., 2005).
Although empirically supported treatments exist for established PTSD and depression, much
less is known about effective early interventions for these conditions. Exploration of early
intervention options is necessary, particularly in the case of the new veteran population, as
such interventions could address social, occupational and physical impairments before they
become too intractable. Also, successful early interventions could curtail high health care
utilization dramatically across time. The development of such early interventions for PTSD
and depression must also take into account any specifications of accessibility and
acceptability that are particular to the OIF/OEF veteran population.
The present study is a randomized, controlled trial that compares Behavioral Activation (BA),
to Treatment As Usual (TAU) as early interventions for OIF/OEF veterans with posttraumatic
stress disorder (PTSD). Participants will be recruited largely from the primary health care
setting (to increase acceptability and accessibility to the veteran population). Both BA and
TAU treatment groups will be administered by psychotherapists who specialize in the treatment
of PTSD. Both groups will be assessed at pre-, mid- and post-treatment time points to
determine change over time, health care utilization and treatment satisfaction. This is a
dual-site study that will be carried out at both the Portland VA Medical Center (PVAMC) and
the VA Puget Sound Health Care Center (VA PSHCS) and coordinated at the PVAMC.
Inclusion Criteria:
- Ability to comply with assessment and therapy schedule.
- Ability to comply with study regulations.
- English fluency.
- Must meet diagnostic criteria for PTSD (related to trauma experienced during military
service). PTSD will be assessed using the Clinician-Administered PTSD Scale for DSM-IV
(CAPS; Blake, Weathers, Nagy, Kaloupek, Charney & Keane, 2003).
Exclusion Criteria:
- Bipolar disorder.
- Psychotic disorders.
- Substance dependence. Because these conditions warrant alternative treatments.
Bipolar, psychotic and substance dependence disorders will be assessed using the
Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I; First, Spitzer,
Gibbon & Williams, 2002).
- Report active and imminent suicidal intent. If imminent suicidality is present, this
would suggest that a treatment specifically targeting this intent is indicated.
Suicidal intent will be assessed using The Brief Assessment for Suicidal Ideation or
Behavior that was designed for this study.
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