Citation

Brown LA, McLean CP, Zang Y, Zandberg L, Mintz J, Yarvis JS, Litz BT, Peterson AL, Bryan CJ, Fina B, Petersen J, Dondanville KA, Roache JD, Young-McCaughan S, Foa EB. Behav. Res. Ther. 2019; 118: 87-93.

Affiliation

Department of Psychiatry, University of Pennsylvania, 3535 Market St., Suite 600 North, Philadelphia, PA, USA.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.brat.2019.04.003

PMID

31022593

Abstract

The efficacy of prolonged exposure (PE) on suicide ideation (SI) as a secondary outcome among individuals with posttraumatic stress disorder (PTSD) is unclear. The purpose of this study was to compare the efficacy of PE in two formats (spaced, S-PE, 10 sessions over 8 weeks, and massed, M-PE, 10 sessions over 2 weeks) to Present Centered Therapy (PCT) and minimal contact control (MCC) on SI exacerbation among patients without suicide intent or plans. Active duty military personnel (n = 335) were randomized to: (1) S-PE vs. PCT and (2) M-PE vs. MCC. All participants completed the Beck Scale for Suicide Ideation and the Beck Depression Inventory (Suicide item) at baseline, posttreatment, and follow-ups. S-PE and PCT had significant and comparable reductions in SI during treatment. M-PE had significantly steeper reductions in SI during treatment compared to MCC. Specifically, more participants in M-PE compared to MCC had reliable improvement versus reliable exacerbation. Reduction in PTSD symptoms was significantly associated with reduction of SI. PE was associated with significant reductions in SI over time that were comparable to PCT and superior to MCC. These findings suggest that both trauma- and non-trauma-focused treatments are associated with reductions in SI, and that trauma-focused treatments improve SI relative to waitlist.

Copyright © 2019 Elsevier Ltd. All rights reserved.

Language: en

Keywords

Active duty military; PTSD; Prolonged exposure; Suicide