Citation

Berke DS, Kline NK, Wachen JS, McLean CP, Yarvis JS, Mintz J, Young-McCaughan S, Peterson AL, Foa E, Resick PA, Litz BT. Behav. Res. Ther. 2019; 118: 7-17.

Affiliation

Massachusetts Veterans Epidemiological Research and Information Center, VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA; Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA. Electronic address: brett.litz@va.gov.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.brat.2019.03.003

PMID

30933748

Abstract

Dropout from first-line posttraumatic stress disorder (PTSD) treatments is a significant problem. We reported rates and predictors of attendance and dropout in three clinical trials of evidence-based PTSD treatments in military service members (N = 557). Service members attended 81.0% of treatment sessions and 30.7% dropped out. Individually delivered treatment was associated with greater attendance rates (β = 0.23, p < .001) than group therapy; trauma-focused treatments were associated with higher dropout (β = 0.19, p < .001) than Present-Centered Therapy. Age was a significant predictor of session attendance (β = 0.17, p < .001) and drop out (β = -0.23, p < .001). History of traumatic brain injury (TBI) predicted lower attendance rates (β = -0.26, p < .001) and greater dropout (β = 0.19, p < .001). Regardless of treatment type or format, patients who did not drop out were more likely to experience clinically significant gains (d = 0.49, p < .001).

RESULTS demonstrate that dropout from PTSD treatments in these trials was significantly associated with treatment outcome and suggest that strategies are needed to mitigate dropout, particularly in group and trauma-focused therapies, and among younger service members and those with TBI.

Published by Elsevier Ltd.

Language: en

Keywords

Active duty service members; Attendance; Clinical trial; Dropout; PTSD