Exposure Therapy For Veterans With PTSD And Panic Attacks

Study Overview
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Brief Summary
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To evaluate the feasibility, acceptability and effectiveness of Multiple Channel Exposure Therapy-Veterans (MCET-V) as a treatment for returning service members with comorbid PTSD and panic disorder (PD). This study will examine the effectiveness of MCET-V by comparing it to Cognitive Processing Therapy, a standard PTSD treatment.

Detailed Description
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With the increasing number of Operations Iraqi Freedom and Enduring Freedom (OIF/OEF) Veterans returning from war-zone areas, many will experience anxiety disorders such as PTSD and comorbid problems. Currently, about one in every six OIF/OEF Veterans experiences PTSD and co-occurring PD. Although effective treatments exist for treating one or the other, we do not yet have treatments that can simultaneously target PTSD and PD. Thus, recent attention has focused on the development of multi-component treatments that simultaneously address PTSD and PD. This study is the first systematic investigation of a time-limited, multi-component cognitive-behavioral treatment for Veterans with specific comorbid anxiety problems. The purpose of the study is to evaluate the effectiveness of the multi-component cognitive-behavioral treatment in comparison to standard PTSD treatment in military personnel returning from active duty.

Official Title
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Exposure Therapy for Veterans With PTSD and Panic Attacks

Conditions
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PTSD, Panic Attacks

Intervention / Treatment
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* Behavioral: Multiple Channel Exposure Therapy - Veterans
* Behavioral: Cognitive Processing Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: being a Veteran of any era; being enrolled in the TRP at the MEDVAMC, with a current diagnosis of PTSD and PD; being stable on psychotropic medication for 4 weeks before study participation; and being at least 18 years of age. Exclusion Criteria: active substance dependence, or bipolar or psychotic disorders; severe depression and [active suicidal ideation and intent] (based on ADIS-IV & BDI-II); cognitive impairment as indicated by the SLUMS; and Veterans currently receiving psychosocial treatment specifically targeting PTSD or panic symptoms.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Single Group Assignment
Interventional Model Description: Multiple Channel Exposure Therapy is a behavioral treatment that simultaneously targets panic disorder and PTSD.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: MCET-V<br>Multiple Channel Exposure Therapy -Veterans (MCET-V) is a 12-session cognitive-behavioral treatment for persons with comorbid PTSD and panic attacks. It is an integrated treatment designed to target panic and PTSD symptoms simultaneously. | Behavioral: Multiple Channel Exposure Therapy - Veterans<br>* MCET-V offers individual therapy that provides psychoeducation about panic attacks and trauma and involves behavioral and cognitive exposure exercises.<br>* Other names: MCET-V;|
| Active Comparator: CPT<br>Cognitive Processing Therapy (CPT) is a 12-session cognitive-behavioral treatment for persons with PTSD. It is a gold-standard cognitive behavioral intervention designed to target PTSD symptoms. | Behavioral: Cognitive Processing Therapy<br>* CPT offers individual therapy that targets trauma and PTSD symptoms via cognitive restructuring.<br>* Other names: CPT;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in PTSD Symptoms (CAPS) Between MCET-V and CPT Groups | The CAPS is a clinician-administered assessment of the presence and severity of PTSD symptoms. Scores range from 0 - 136, with higher scores indicating greater symptom severity. | Baseline, 1-week post-treatment and 3-month follow-up | 
| Change in PDSS Scores Over Time for MCET-V and CPT Groups | The Panic Disorder Severity Scale (PDSS) is a clinician-rated assessment of the presence and severity of panic symptoms. Scores range from 0 - 28, with higher scores indicating greater symptom severity. | Baseline, 1-week post, and 3-month follow-up |