Treatment adherence in cognitive processing therapy for combat-related PTSD with history of mild TBI

Rehabil Psychol. 2013 Feb;58(1):36-42. doi: 10.1037/a0031525.

Abstract

Objective: This retrospective study examined treatment adherence in Cognitive Processing Therapy (CPT) for combat-related posttraumatic stress disorder (PTSD) in Veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) with and without history of mild traumatic brain injury (mTBI).

Method: Medical record review of consecutive referrals to an outpatient PTSD clinic identified veterans diagnosed with combat-related PTSD who began treatment with CPT. The sample (N = 136) was grouped according to positive (n = 44) and negative (n = 92) mTBI history. Groups were compared in terms of presenting symptoms and treatment adherence.

Results: The groups were not different on a pretreatment measure of depression, but self-reported and clinician-rated PTSD symptoms were higher in veterans with history of mTBI. The treatment completion rate was greater than 61% in both groups. The number of sessions attended averaged 9.6 for the PTSD group and 7.9 for the mTBI/PTSD group (p = .05).

Implications: Given the lack of marked group differences in treatment adherence, these initial findings suggest that standard CPT for PTSD may be a tolerable treatment for OEF/OIF veterans with a history of PTSD and mTBI as well as veterans with PTSD alone.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Afghan Campaign 2001-*
  • Ambulatory Care
  • Brain Concussion / diagnosis
  • Brain Concussion / psychology*
  • Brain Concussion / rehabilitation*
  • Cognitive Behavioral Therapy*
  • Combat Disorders / diagnosis
  • Combat Disorders / psychology*
  • Combat Disorders / rehabilitation*
  • Comorbidity
  • Depressive Disorder / psychology
  • Depressive Disorder / rehabilitation
  • Disability Evaluation
  • Hospitals, Veterans
  • Humans
  • Iraq War, 2003-2011*
  • Male
  • Midwestern United States
  • Patient Compliance / psychology*
  • Personality Inventory / statistics & numerical data
  • Psychometrics
  • Retrospective Studies
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / psychology*
  • Stress Disorders, Post-Traumatic / rehabilitation*
  • Veterans / psychology*