Written by Jeremy Schwartz
A recent Fort Hood-based study holds hope for a speedy recovery from post-traumatic stress disorder (PTSD) symptoms — in as little as two weeks — for service members returning from combat.
Researchers say the study, which involved 370 active-duty service members seeking PTSD treatment, has already led to a Defense Department directive to make the treatment more available at its clinics on military installations across the country.
At Fort Hood’s Carl R. Darnall Army Medical Center, researchers studied the effect of prolonged exposure therapy, in which patients repeatedly recounted and discussed their most traumatic memories to process the trauma they experienced and reduce the anxiety caused by the memories. Service members listened to recordings of those episodes, practiced confronting real-life situations that spark anxiety and did controlled breathing exercises.
The therapy previously had shown success among civilians, but the length of the treatment — eight to 15 weeks — can make it difficult for service members to complete it.
But the Texas study found that two weeks of intensive daily treatment were as effective as a traditional eight-week course. Almost half of the study participants no longer tested positive for PTSD after the treatment, gains that researchers said largely held up over time.
“The shorter treatment is an optimal intervention for military personnel with PTSD, as it minimizes the time and inconvenience entailed by a longer treatment before continuing their military career or returning to civilian life,” said Edna Foa, a University of Pennsylvania clinical psychology and psychiatry professor, who developed prolonged exposure therapy and led the study.
The study, the first-ever randomized clinical trial of prolonged exposure therapy with active-duty military personnel and the largest study yet of prolonged exposure therapy, was carried out by researchers affiliated with the STRONG STAR consortium, a multi-institutional research network funded by the Defense Department aimed at researching combat-related PTSD treatments.
In 2016, STRONG STAR announced the results of another Fort Hood study that found 12 sessions of therapy led to PTSD recovery in 40 to 50 percent of soldiers. Instead of confronting traumatic memories directly as in prolonged exposure therapy, cognitive processing therapy helps patients learn to think about their traumatic experiences in a clearer way, without “distorted thoughts” that perpetuate feelings of guilt, blame and anger, researchers said.
STRONG STAR researchers are slated to train Defense Department clinicians who treat special operations forces troops on the two-week prolonged exposure therapy. Alan Peterson, a psychiatry professor at the University of Texas Health Science Center at San Antonio who directs the STRONG STAR consortium, said a short, intensive treatment would be more feasible given the schedules of elite troops.
Despite the promising results, combat-related PTSD remains more difficult to treat than other forms of PTSD. Recovery rates among civilians using prolonged exposure therapy are up to 80 percent, compared with about 50 percent for military veterans.
“Our findings are good news — about half of those treated can be treated into remission,” Peterson said. “This is critical for the hundreds of thousands of post-9/11 combat veterans affected by PTSD and can do so much to improve lives and assist with military readiness. Still, we need to identify the specific factors with combat PTSD — the things that make it more difficult to treat — and then enhance the treatments to tackle those challenges.”