Are 60-Minute Prolonged Exposure Sessions With 20-Minute Imaginal Exposure to Traumatic Memories Sufficient to Successfully Treat PTSD? A Randomized Noninferiority Clinical Trial

Behavior Therapy

Volumn 46, Issue 3, 2015, Pages 328-341

  Nacasch, Nitsa ^a   Huppert, Jonathan D ^b   Su, Yi Jen ^c   Kivity, Yogev ^b   Dinshtein, Yula ^a   Yeh, Rebecca ^d   Foa, Edna B ^d  

^a TEL AVIV COMMUNITY MENTAL HEALTH CENTER   (Israel)

^b HEBREW UNIVERSITY OF JERUSALEM   (Israel)

^c NATIONAL TAIWAN UNIVERSITY   (Taiwan)

^d UNIVERSITY OF PENNSYLVANIA   (United States)

Author keywords

Emotional processing; Fear activation; Habituation; Posttraumatic stress disorder; Prolonged exposure

Indexed keywords

SEROTONIN NORADRENALIN REUPTAKE INHIBITOR; SEROTONIN UPTAKE INHIBITOR;

ADULT; ARTICLE; BEHAVIOR THERAPY; CHRONIC DISEASE; CLINICAL ARTICLE; CLINICAL EFFECTIVENESS; CONTROLLED STUDY; DEPRESSION; DISEASE SEVERITY; EMOTIONALITY; FEMALE; FOLLOW UP; HABITUATION; HUMAN; INTERMETHOD COMPARISON; MALE; POSTTRAUMATIC STRESS DISORDER; PSYCHOLOGIC ASSESSMENT; RANDOMIZED CONTROLLED TRIAL; SELF REPORT; TREATMENT DURATION; COMPARATIVE STUDY; MIDDLE AGED; PROCEDURES; PSYCHOLOGY; STRESS DISORDERS, POST-TRAUMATIC; TREATMENT OUTCOME; VETERAN; YOUNG ADULT;

ADULT; DEPRESSION; FEMALE; HUMANS; IMPLOSIVE THERAPY; MALE; MIDDLE AGED; STRESS DISORDERS, POST-TRAUMATIC; TREATMENT OUTCOME; VETERANS; YOUNG ADULT;

EID: 84942806808     PISSN: 00057894     EISSN: 18781888     Source Type: Journal    
DOI: 10.1016/j.beth.2014.12.002     Document Type: Article

References (45)

1. Beck A.T., Ward C.H., Mendelson M., Mock J., Erbaugh J. An inventory for measuring depression. Archives of General Psychiatry 1961, 4:561-571. 10.1001/archpsyc.1961.01710120031004.
2. Beck A.T., Steer R.A., Garbin M.G. Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review 1988, 8(1):77-100.
3. Blackwelder W.C. Current issues in clinical equivalence trials. Journal of Dental Research 2004, 83:C113-C115.
4. Brewin C.R. Understanding cognitive behaviour therapy: A retrieval competition account. Behaviour Research and Therapy 2006, 44(6):765-784.
5. Bryant R.A., Moulds M.L., Guthrie R.M., Dang S.T., Mastrodomenico J., Nixon R.D.V., Creamer M. A randomized controlled trial of exposure therapy and cognitive restructuring for posttraumatic stress disorder. Journal of Consulting and Clinical Psychology 2008, 76:695-703. 10.1037/a0012616.
6. Bryant R.A., Moulds M.L., Guthrie R.M., Dang S.T., Nixon R.D.V. Imaginal exposure alone and imaginal exposure with cognitive restructuring in treatment of posttraumatic stress disorder. Journal of Consulting and Clinical Psychology 2003, 71:706-712. 10.1037/0022-006X.71.4.706.
7. Chaplin E.W., Levine B.A. The effects of total exposure duration and interrupted versus continuous exposure in flooding therapy. Behavior Therapy 1981, 12:360-368. 10.1016/S0005-7894(81)80124-4.
8. Cohen J. Statistical power analysis for the behavioral sciences 1988, Erlbaum, Hillsdale, NJ.
9. Devilly G.J., Foa E.B. The investigation of exposure and cognitive therapy: Comment on Tarrier et al. (1999). Journal of Consulting and Clinical Psychology 2001, 69:114-116. 10.1037/0022-006X.69.1.114.
10. Eftekhari A., Ruzek J.I., Crowley J.J., Rosen C.S., Greenbaum M.A., Karlin B.E. Effectiveness of national implementation of prolonged exposure therapy in veterans affairs care. JAMA Psychiatry 2013, 70:949-955. 10.1001/jamapsychiatry.2013.36.
11. First M.B., Spitzer R.L., Gibbon M., Williams J.B.W. Structured clinical interview for Axis I DSM-IV disorders 1994, Biometrics Research, New York, NY.
12. Foa E.B., Cahill S.P. Psychological therapies: Emotional processing. International encyclopedia of the social and behavioral sciences 2001, 12363-12369. Elsevier, Oxford, UK. S. N. J. B. P. B. (Ed.).
13. Foa E.B., Dancu C.V., Hembree E.A., Jaycox L.H., Meadows E.A., Street G.P. A comparison of exposure therapy, stress inoculation training, and their combination for reducing posttraumatic stress disorder in female assault victims. Journal of Consulting and Clinical Psychology 1999, 67:194-200.
14. Foa E.B., Ehlers A., Clark D.M., Tolin D.F., Orsillo S.M. The Posttraumatic Cognitions Inventory (PTCI): Development and validation. Psychological Assessment 1999, 11:303-314. 10.1037/1040-3590.11.3.303.
15. Foa E.B., Hembree E.A., Cahill S.P., Rauch S.A., Riggs D.S., Feeny N.C., Yadin E. Randomized trial of prolonged exposure for posttraumatic stress disorder with and without cognitive restructuring: Outcome at academic and community clinics. Journal of Consulting and Clinical Psychology 2005, 73:953-964. 10.1037/0022-006X.73.5.953.
16. Foa E.B., Hembree E.A., Rothbaum B.O. Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences: Therapist guide 2007, Oxford University Press, New York, NY.
17. Foa E.B., Huppert J.D., Cahill S.P. Emotional processing theory: An update. Pathological anxiety: Emotional processing in etiology and treatment 2006, 3-24. Guildford Press, New York, NY. B.O. Rothbaum (Ed.).
18. Foa E.B., Kozak M.J. Emotional processing of fear: Exposure to corrective information. Psychological Bulletin 1986, 99:20-35. 10.1037/0033-2909.99.1.20.
19. Foa E.B., Rauch S.A. Cognitive changes during prolonged exposure versus prolonged exposure plus cognitive restructuring in female assault survivors with posttraumatic stress disorder. Journal of Consulting and Clinical Psychology 2004, 72:879-884. 10.1037/0022-006X.72.5.879.
20. Foa E.B., Riggs D.S., Dancu C.V., Rothbaum B.O. Reliability and validity of a brief instrument for assessing post-traumatic stress disorder. Journal of Traumatic Stress 1993, 6:459-473. 10.1002/jts.2490060405.
21. Foa E.B., Tolin D.F. Comparison of the PTSD Symptom Scale-Interview version and the clinician-administered PTSD scale. Journal of Traumatic Stress 2000, 13:181-191. 10.1023/A:1007781909213.
22. Hoenig J.M., Heisey D.M. The abuse of power. The American Statistician 2001, 55:19-24. 10.1198/000313001300339897.
23. Jacobson N.S., Truax P. Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology 1991, 59:12-19. 10.1037/0022-006X.59.1.12.
24. Jaycox L.H., Foa E.B., Morral A.R. Influence of emotional engagement and habituation on exposure therapy for PTSD. Journal of Consulting and Clinical Psychology 1998, 66:185.
25. Julious S.A. Sample sizes for clinical trials with normal data. Statistics in Medicine 2004, 23:1921-1986. 10.1002/sim.1783.
26. Karlin B.E., Ruzek J.I., Chard K.M., Eftekhari A., Monson C.M., Hembree E.A., Foa E.B. Dissemination of evidence-based psychological treatments for posttraumatic stress disorder in the Veterans Health Administration. Journal of Traumatic Stress 2010, 23:663-673. 10.1002/jts.20588.
27. Kozak M.J., Foa E.B., Steketee G. Process and outcome of exposure treatment with obsessive-compulsives: Psychophysiological indicators of emotional processing. Behavor Therapy 1988, 19:157-169. 10.1016/S0005-7894(88)80039-X.
28. Lenth R.V. Some practical guidelines for effective sample size determination. The American Statistician 2001, 55:187-193. 10.1198/000313001317098149.
29. Marks I., Lovell K., Noshirvani H., Livanou M., Thrasher S. Treatment of posttraumatic stress disorder by exposure and/or cognitive restructuring: A controlled study. Archives of General Psychiatry 1998, 55:317-325. 10.1001/archpsyc.55.4.317.
30. McLean C.P., Foa E.B. Prolonged exposure therapy for post-traumatic stress disorder: A review of evidence and dissemination. Expert Review of Neurotherapeutics 2011, 11:1151-1163. [Review]. 10.1586/ern.11.94.
31. McLean, C. P., Su, Y. J., & Foa, E. B. (2015). Mechanisms of symptom reduction in a combined treatment for comorbid posttraumatic stress disorder and alcohol dependence. Manuscript in preparation.
32. Nacasch N., Foa E.B., Huppert J.D., Tzur D., Fostick L., Dinstein Y., Zohar J. Prolonged exposure therapy for combat- and terror-related posttraumatic stress disorder: A randomized control comparison with treatment as usual. Journal of Clinical Psychiatry 2011, 72:1174-1180. 10.4088/JCP.09m05682blu.
33. Oliver J.M., Simmons M.E. Affective disorders and depression as measured by the Diagnostic Interview Schedule and the Beck Depression Inventory in an unselected adult population. Journal of Clinical Psychology 1985, 41:469-477. 10.1002/1097-4679(198507)41:4<469::AID-JCLP2270410405>3.0.CO;2-R.
34. Powers M.B., Gillihan S.J., Rosenfield D., Jerud A.B., Foa E.B. Reliability and validity of the PDS and PSS-I among participants with PTSD and alcohol dependence. Journal of Anxiety Disorders 2012, 26:617-623. 10.1016/j.janxdis.2012.02.013.
35. Powers M.B., Halpern J.M., Ferenschak M.P., Gillihan S.J., Foa E.B. A meta-analytic review of prolonged exposure for posttraumatic stress disorder. Clinical Psychology Review 2010, 30:635-641. 10.1016/j.cpr.2010.04.007.
36. Rabavilas A.D., Boulougouris J.C., Stefanis C. Duration of flooding sessions in the treatment of obsessive-compulsive patients. Behaviour Research and Therapy 1976, 14:349-355. 10.1016/0005-7967(76)90022-X.
37. Schneier F.R., Neria Y., Pavlicova M., Hembree E., Suh E.J., Amsel L., Marshall R.D. Combined prolonged exposure therapy and paroxetine for PTSD related to the World Trade Center attack: A randomized controlled trial. American Journal of Psychiatry 2012, 169:80-88. 10.1176/appi.ajp.2011.11020321.
38. Sheehan D.V., Lecrubier Y., Sheehan K.H., Amorim P., Janavs J., Weiller E., Dunbar G.C. The Mini-International Neuropsychiatric Interview (MINI): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry 1998, 59:22-33.
39. Tarrier N., Pilgrim H., Sommerfield C., Faragher B., Reynolds M., Graham E., Barrowclough C. A randomized trial of cognitive therapy and imaginal exposure in the treatment of chronic posttraumatic stress disorder. Journal of Consulting and Clinical Psychology 1999, 67:13-18. 10.1037/0022-006X.67.1.13.
40. Tuerk P.W., Yoder M., Grubaugh A., Myrick H., Hamner M., Acierno R. Prolonged exposure therapy for combat-related posttraumatic stress disorder: An examination of treatment effectiveness for veterans of the wars in Afghanistan and Iraq. Journal of Anxiety Disorders 2011, 25:397-403. 10.1016/j.janxdis.2010.11.002.
41. van IJzendoorn M.H., Schuengel C. The measurement of dissociation in normal and clinical populations: Meta-analytic validation of the Dissociative Experiences Scale (DES). Clinical Psychology Review 1996, 16:365-382. 10.1016/0272-7358(96)00006-2.
42. van Minnen A., Foa E.B. The effect of imaginal exposure length on outcome of treatment for PTSD. Journal of Trauma Stress 2006, 19:427-438. 10.1002/jts.20146.
43. van Minnen A., Hagenaars M. Fear activation and habituation patterns as early process predictors of response to prolonged exposure treatment in PTSD. Journal of Traumatic Stress 2002, 15:359-367.
44. Wolpe J., Lazarus A.A. Behavior therapy techniques: A guide to the treatment of neuroses 1966, Pergamon Press, New York, NY.
45. Zalta A.K., Gillihan S.J., Fisher A.J., Mintz J., Cahill S.P., Yehuda R., Foa E.B. Change in trauma-related cognitions drives symptom reduction in prolonged exposure for PTSD. Journal of Consulting and Clinical Psychology 2013, 82:171-175. 10.1037/a0034735.