A Comparison of Cognitive Processing Therapy (CPT) Versus Present Centered Therapy (PCT) for Veterans

Study Overview
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Brief Summary
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The purpose of this study is to compare the effectiveness of Cognitive Processing Therapy (CPT) versus Present Centered Therapy (PCT) for male OEF/OIF Veterans with combat related PTSD.

Detailed Description
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The purpose of this study is to compare the effectiveness of Cognitive Processing Therapy (CPT) versus Present Centered Therapy (PCT) for male OEF/OIF Veterans with combat related PTSD. CPT has been shown to be effective in treating trauma survivors in several treatment outcome studies, but utility with Veterans has only been examined with male Veterans in one small pilot study. In addition CPT has never been compared to a treatment as usual or supportive psychotherapy condition to control for the specific and nonspecific elements of treatment. Although Cognitive Processing Therapy is one of the main treatment modalities at several VA's, including Cincinnati, it has never been compared to PCT, nor has it been used in a large, randomized study of male OEF/OIF Veterans. It is hypothesized that individual receiving CPT will show a larger reduction in posttraumatic stress disorder and related symptoms than those individuals receiving PCT. All male OEF/OIF Veterans will be screened for their appropriateness for the study by phone screen and then by an assessment technician. The Veteran will be assessed at pre, post, 3-month, and 1-year follow-up. The assessment technicians will be blind to the participant's condition. CPT is a 12 week long individual psychotherapy treatment shown to be effective at reducing PTSD and related symptoms for survivors of various types of traumas, including combat. PCT is a supportive counseling treatment that has been utilized as an alternative to waitlist control in VA cooperative studies of PTSD.

Official Title
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A Comparison of CPT vs PCT for Veterans

Conditions
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PTSD

Intervention / Treatment
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* Behavioral: Cognitive Processing Therapy
* Behavioral: Present Centered Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: PTSD; memory of the trauma; able to read/write; must be stable on medication for 3 months Exclusion Criteria: Psychosis; suicidal/homicidal intent; alcohol/substance dependence; no memory of the trauma

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

Sexes Eligible for Study
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Male

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: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Cognitive Processing Therapy<br>Cognitive Processing Therapy | Behavioral: Cognitive Processing Therapy<br>* CPT is a highly structured protocol in which the client learns the skill of recognizing and challenging dysfunctional cognitions, first about the worst traumatic event and then later with regard to the meaning of the events for current beliefs about self and others.<br>|
| Active Comparator: Present Centered Therapy<br>Present Centered Therapy | Behavioral: Present Centered Therapy<br>* Present centered therapy is a supportive counseling model developed by Drs. Foa and Shea. The treatment is called present centered therapy to 1) emphasize the need to focus on the participant's current life and 2) to conceptualize the problems as being caused by PTSD, and in some cases they may have been present for a long period of time. The treatment makes a connection between PTSD and current problems thus making it a more realistic PTSD treatment and still allowing PCT to control for nonspecific therapeutic factors<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Clinician Administered PTSD Scale | Clinician-rated PTSD symptom severity; higher is worse; range at post-treatment is 0 to 80; scale scores are summed. | Post-treatment, at 3 months and 1 year | 
| PTSD Checklist (PCL) | 17-item patient self-reported PTSD severity; higher is worse; range at post-treatment is 17-73; scale scores are summed | post-treatment, at 3 months and 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Beck Depression Inventory - II (BDI-II) | Gold-standard, self-reported depression severity measure; higher is worse; post-treatment range is 2-45. scale scores are summed. | post-treatment, at 3 months and 1 year | 
| State-Trait Anger Scale (STAXI) | Self-reported trait anger; subscale score is summed; higher is worse; range at post-treatment is 10-37. | post-treatment, at 3 months and 1 year | 
| State-Trait Anxiety Scale | Self-reported state anxiety; higher is worse; scale score is summed; range at post-treatment is 20-73. | post-treatment, at 3 months and 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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PTSD, OEF/OIF, Combat, Treatment, CPT, PCT, Cognitive