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PREDICTORS OF COMPLETION OF EXPOSURE THERAPY IN OEF/OIF VETERANS WITH POSTTRAUMATIC STRESS DISORDER

Authors

  • Daniel F. Gros Ph.D.,

    Corresponding author
    1. Mental Health Service Line, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
    2. Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
    • Correspondence to: Daniel F. Gros, Mental Health Service 116, Ralph H. Johnson Veterans Affairs Medical Center (VAMC), 109 Bee Street, Charleston, SC 29401.

      E-mail: grosd@musc.edu

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  • Matthew Price Ph.D.,

    1. Department of Psychology, University of Vermont, Burlington, Vermont
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  • Erica K. Yuen Ph.D.,

    1. Department of Psychology, University of Tampa, Tampa, Florida
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  • Ron Acierno Ph.D.

    1. Mental Health Service Line, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
    2. Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
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  • This research was supported by Department of Defense Grant W81XWH-07-PTSD-IIRA (PI: Acierno). Several authors are also core and affiliate members of the Ralph H. Johnson VAMC Research Enhancement Award Program (REA08–261; PI: Egede), the Center for Disease Prevention and Health Interventions for Diverse Populations. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government. There are no conflicts of interest to disclose.

  • Contract grant sponsor: Department of Defense Grant; Contract grant number: W81XWH-07-PTSD-IIRA (PI: Acierno)

Abstract

Background

Despite large-scale dissemination and implementation efforts of evidence-based psychotherapy to veterans from Operation Enduring/Iraqi Freedom (OEF/OIF), little is known regarding the factors that contribute to the successful completion of these treatments in this high-risk population. The present study investigated predictors of treatment completion during a standardized exposure-based psychotherapy for PTSD.

Methods

Ninety-two OEF/OIF combat veterans enrolled in a randomized controlled trial for an eight session exposure-based psychotherapy for PTSD. All participants completed structured clinical interviews and several background and symptom questionnaires. Of the initial 92 participants, 28% of the sample (n = 26) discontinued treatment prior to completion of the trial.

Results

Predictors of discontinuation of treatment were assessed with a hierarchical logistic regression. Disability status was positively associated with treatment discontinuation, and postdeployment social support was negatively associated with discontinuation. In contrast to previous findings, other factors, such as age and PTSD symptomatology, were not identified as significant predictors.

Conclusions

The present study suggested that disability status at the start of treatment increases the risk for treatment discontinuation whereas increased social support buffers against discontinuation. Together, these findings highlight the importance of increased assessment and early intervention when these factors are present to potentially reduce treatment discontinuation and improve treatment outcomes in OEF/OIF veterans with PTSD.

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