Effectiveness of Three Different Psychotherapies for Chronic Post-Traumatic Stress Disorder
Condition: Post-Traumatic Stress Disorder
MeSH terms: Stress Disorders, Traumatic; Stress Disorders, Post-Traumatic
Study type: Interventional

Summary: 
      This study will examine whether interpersonal psychotherapy is as effective in treating
      post-traumatic stress disorder as the established therapies of prolonged exposure and
      relaxation.
    

Detailed description: 
      Post-traumatic stress disorder (PTSD) is caused by a traumatic experience often involving
      physical harm or the threat of harm or death. The emotional numbness and traumatic flashbacks
      symptomatic of PTSD interfere with everyday life for approximately 7.7 million adults.
      Besides prescription drug treatment, only exposure-based therapies, like prolonged exposure
      (PE) therapy, have been proved effective in treating PTSD. Interpersonal psychotherapy (IPT),
      which is not based on exposure, is effective in treating mood disorders, and pilot studies
      indicate it may also be effective in treating PTSD. IPT treats patients by helping them to
      improve their interpersonal functioning, as opposed to PE, which helps patients by guiding
      them to recreate traumatic memories in safe circumstances. This study will determine whether
      IPT is as effective as PE, the gold standard, in treating PTSD. Relaxation therapy, a
      commonly used control therapy for studies of PTSD, will be used for that purpose here.

      All participants will be screened for PTSD, with those meeting the criteria being randomly
      assigned to one of the following three treatment groups:

        -  Group 1 participants will receive IPT. They will meet weekly for fourteen 50-minute
           sessions focusing on interpersonal consequences of the trauma affecting them and their
           relationships with others.

        -  Group 2 participants will receive PE. They will meet for 10, unevenly spaced 90-minute
           sessions during which they will face the trauma responsible for their symptoms.

        -  Group 3 participants will receive relaxation therapy. They will meet for nine 90-minute
           sessions and one 30-minute session during which they will learn relaxation methods.

      All treatments will last 14 weeks, with assessments made by mental health professionals at
      screening, the midpoint of the study, the end of the study, and a 3-month follow-up. PTSD
      symptoms will be assessed through clinical interviews and self-report measures. In addition,
      participants will complete other interviews and tests that will examine a variety of factors
      relating to mental health, including comorbidity of other conditions, affect, social
      functioning, and quality of life.
    

Intervention name(s): Interpersonal Psychotherapy; Prolonged Exposure Therapy; Relaxation Therapy
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): 14 weekly 50-minute sessions of interpersonal psychotherapy, a time-limited treatment that focuses on interpersonal functioning and social supports; Ten 90-minute sessions, distributed over 14 weeks, of prolonged exposure, which involves the repeated, detailed recounting of the trauma to develop a coherent narrative and repeated exposure to reminders of the trauma; Nine 90-minute sessions and one 30-minute session, distributed over 14 weeks, that focus on muscle relaxation to address the physical symptoms of PTSD
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized controlled trial of three time-limited (14 week) psychotherapies for unmedicated patients with chronic posttraumatic stress disorder (PTSD)
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Trauma; Psychotherapy; Anxiety