Comparative Effectiveness of Two Treatments for Veterans With PTSD
| Status: | Recruiting |
|---|---|
| Conditions: | Psychiatric, Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 12/15/2018 |
| Start Date: | September 1, 2016 |
| End Date: | December 31, 2019 |
| Contact: | Tracie M Shea, PhD |
| Email: | Tracie.Shea@va.gov |
Interpersonal Therapy for Veterans With PTSD
Interpersonal problems such as relationship conflict and social isolation are common among
Veterans with PTSD and serve as barriers to successful posttraumatic adjustment. The main
interventions for PTSD at VA facilities, i.e., Prolonged Exposure, Cognitive Processing
Therapy, and Trauma-Focused CBT, do not directly target these relationship difficulties and
many Veterans do not complete these treatments. Couple and family approaches for PTSD address
relationship problems, but logistical problems make it difficult for couples to attend
sessions and these approaches do not involve Veterans who are socially isolated or unmarried.
There is accumulating evidence that Interpersonal Psychotherapy (IPT) for PTSD may be
effective in reducing symptoms and improving interpersonal functioning. This study, a
randomized controlled trial, aims to provide evidence regarding whether IPT for PTSD could be
a useful addition to current treatments delivered at the VA.
Veterans with PTSD and serve as barriers to successful posttraumatic adjustment. The main
interventions for PTSD at VA facilities, i.e., Prolonged Exposure, Cognitive Processing
Therapy, and Trauma-Focused CBT, do not directly target these relationship difficulties and
many Veterans do not complete these treatments. Couple and family approaches for PTSD address
relationship problems, but logistical problems make it difficult for couples to attend
sessions and these approaches do not involve Veterans who are socially isolated or unmarried.
There is accumulating evidence that Interpersonal Psychotherapy (IPT) for PTSD may be
effective in reducing symptoms and improving interpersonal functioning. This study, a
randomized controlled trial, aims to provide evidence regarding whether IPT for PTSD could be
a useful addition to current treatments delivered at the VA.
The strong relationship between posttraumatic stress disorder (PTSD) and interpersonal
problems is well documented. PTSD is highly associated with relationship discord, increased
intimate partner violence, and difficulties in connecting with others, leading to social
isolation. These types of conflicts, as well as the social withdrawal that is common among
Veterans with PTSD, diminish the Veteran's opportunities for interaction with supportive
others, and serve as a barrier to successful posttraumatic adjustment. Treatments that have
been "rolled out" nationally in VAMCs, e.g., Prolonged Exposure, Cognitive Processing
Therapy, and Trauma-Focused CBT, do not directly target these relationship difficulties.
Furthermore, data show that only a limited number of Veterans has fully engaged with these
interventions. Evidence-based interventions of couples therapy are available, but are not
logistically feasible for many couples and do not address the problems of those who are
socially isolated. This application proposes a randomized clinical trial of Interpersonal
Psychotherapy (IPT-PTSD) as a treatment for Veterans with PTSD and relationship problems.
Pilot data suggest that this type of treatment may provide a useful alternative strategy for
Veterans who would prefer an individual, relationship-focused approach. The investigators
propose comparing IPT-PTSD with Prolonged Exposure (PE), an evidence based treatment for PTSD
used in the VHA system. The investigators hypothesize that IPT-PTSD will be statistically
equivalent to PE in reducing PTSD symptom severity, and superior to PE in improving
interpersonal functioning. IPT-PTSD is also hypothesized to be more effective than PE in
improving social adjustment and quality of life. Exploratory analyses will examine whether
IPT-PTSD is more effective than PE in reducing suicidal ideation, and will examine
hypothesized mediators of improvement in PTSD symptoms in IPT-PTSD.
problems is well documented. PTSD is highly associated with relationship discord, increased
intimate partner violence, and difficulties in connecting with others, leading to social
isolation. These types of conflicts, as well as the social withdrawal that is common among
Veterans with PTSD, diminish the Veteran's opportunities for interaction with supportive
others, and serve as a barrier to successful posttraumatic adjustment. Treatments that have
been "rolled out" nationally in VAMCs, e.g., Prolonged Exposure, Cognitive Processing
Therapy, and Trauma-Focused CBT, do not directly target these relationship difficulties.
Furthermore, data show that only a limited number of Veterans has fully engaged with these
interventions. Evidence-based interventions of couples therapy are available, but are not
logistically feasible for many couples and do not address the problems of those who are
socially isolated. This application proposes a randomized clinical trial of Interpersonal
Psychotherapy (IPT-PTSD) as a treatment for Veterans with PTSD and relationship problems.
Pilot data suggest that this type of treatment may provide a useful alternative strategy for
Veterans who would prefer an individual, relationship-focused approach. The investigators
propose comparing IPT-PTSD with Prolonged Exposure (PE), an evidence based treatment for PTSD
used in the VHA system. The investigators hypothesize that IPT-PTSD will be statistically
equivalent to PE in reducing PTSD symptom severity, and superior to PE in improving
interpersonal functioning. IPT-PTSD is also hypothesized to be more effective than PE in
improving social adjustment and quality of life. Exploratory analyses will examine whether
IPT-PTSD is more effective than PE in reducing suicidal ideation, and will examine
hypothesized mediators of improvement in PTSD symptoms in IPT-PTSD.
Inclusion Criteria:
- Veterans age 18 or older
- Experienced trauma while deployed to a war zone
- Meet DSM-5 criteria for PTSD and a minimum CAPS-5 score of 23
- Have at least one area of relationship dysfunction
- Consent to be randomized
Exclusion Criteria:
- Current severe substance use disorder
- Current psychotic symptoms
- Current mania or un-medicated Bipolar Disorder
- Imminent threat of suicide or homicide
- Victim or perpetrator of severe domestic violence in the past 12 months
- Currently receiving Cognitive Behavioral Therapy for PTSD
- Psychotropic medication start or dosage change within the prior 4 weeks
We found this trial at
2
sites
Providence, Rhode Island 02908
Principal Investigator: Tracie M. Shea, PhD
Phone: 401-273-7100
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New Orleans, Louisiana 70112
Phone: 504-571-8292
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