Adaptive Disclosure: A Combat-Specific PTSD Treatment
Abstract
More than 2 million U.S. troops have served in the wars in Afghanistan and Iraq. Findings from epidemiologic studies of infantry troops in the early stages of the wars suggest that 10-18% of combat troops experience deployment-related psychological health problems, such as posttraumatic stress disorder (PTSD). Once service members and new Veterans develop sustained mental health problems related to combat and operational stress, many are at risk to remain chronic across the lifespan. Thus, primary and secondary prevention of PTSD is a critical challenge for the military and the VA. We have developed a novel intervention, Adaptive Disclosure (AD), to address these needs. AD is a hybrid and extension of evidence-informed cognitive-behavioral therapy strategies packaged and sequenced to target the three high base-rate combat and operational traumas, namely, life-threat trauma, loss (principally traumatic loss), and experiences that produce inner moral conflict. AD employs a Prolonged Exposure (PE) strategy (imaginal emotional processing of an event) and cognitive-therapy-based techniques used in Cognitive Processing Therapy (CPT), but it also includes gestalt-therapy techniques designed to target loss and moral injury. In our open pilot trial, we demonstrated treatment acceptability among Marines and large reductions in PTSD and comborbid symptoms. The primary objective of the current randomized control noninferiority trial is to determine whether AD is as least as effective as CPT, cognitive only version (CPT-C), in terms of its impact on deployment-related psychological health problems (specifically PTSD and depression) and functioning. As secondary aims, we have specified some comparisons in which we believe that AD will be superior to CPT-C (degree of change in posttraumatic grief, moral injury, resilience, and posttraumatic growth, as well as degree of treatment acceptability) and we propose to evaluate a posited mechanism of change (trauma-related cognition).
Document Details
- Document Type
- Technical Report
- Publication Date
- Oct 01, 2012
- Accession Number
- ADA584969
Entities
People
- Brett T Litz
- Maria M Steenkamp
Organizations
- Boston VA Research Institute