Reij Kirsten M, de Jongh Ad, Swens Ernst Paul, Voorendonk Eline M
Research Department, PSYTREC, Bilthoven, the Netherlands.
Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, and VU University Amsterdam, Amsterdam, the Netherlands.
Eur J Psychotraumatol. 2025 Dec;16(1):2511571. doi: 10.1080/20008066.2025.2511571. Epub 2025 Jun 19.
Evidence suggests that veterans with post-traumatic stress disorder (PTSD) are less likely to benefit from trauma-focused treatment than are patients with PTSD who have not been exposed to war-related trauma. However, new developments in PTSD treatment that combine several evidence-based trauma-focused therapies within a short time frame may help veterans achieve outcomes similar to those of non-veterans. In this retrospective cohort study, we examined changes in PTSD symptoms and diagnostic status after treatment between veterans and non-veterans. The treatment consisted of a four- or eight-day intensive trauma-focused treatment programme that integrated prolonged exposure, EMDR therapy, psycho-education, and physical activities. The sample consisted of 43 veterans and 43 non-veterans, matched based on age, sex, starting date, and duration of treatment. Participants were assessed pre- and post-treatment using the Clinician-Administered PTSD Scale-5 (CAPS-5). The differences in CAPS-5 scores over time and between groups were modelled using Bayesian repeated-measures ANOVA. We performed Bayesian model averaging to quantify the differences in PTSD symptom changes between groups, based on treatment response, using the exclusion Bayes factor (). PTSD symptoms in both veterans and non-veterans decreased between pre- and post-treatment (Cohen's = 2.17 and 1.54, respectively). Furthermore, we found moderate evidence of no differences in CAPS-5 scores between the groups ( = 4.8) or between the groups over time ( = 4.9). Although a greater proportion of veterans showed improvement according to the reliable change index than non-veterans (83.7% and 74.4%, respectively), there was no difference between the groups in terms of loss of diagnostic status after treatment (74.4% for veterans and 76.7% for non-veterans). This study provides evidence that veterans with war-related PTSD can benefit from brief intensive, trauma-focused treatment and does not support the notion that veterans need a different treatment approach in such settings.
有证据表明,与未经历与战争相关创伤的创伤后应激障碍(PTSD)患者相比,患有PTSD的退伍军人从创伤聚焦治疗中获益的可能性较小。然而,PTSD治疗的新进展是在短时间内结合多种循证创伤聚焦疗法,这可能有助于退伍军人取得与非退伍军人相似的治疗效果。在这项回顾性队列研究中,我们检查了退伍军人和非退伍军人治疗后PTSD症状和诊断状态的变化。治疗包括一个为期四天或八天的强化创伤聚焦治疗方案,该方案整合了延长暴露疗法、眼动脱敏再处理疗法(EMDR)、心理教育和体育活动。样本包括43名退伍军人和43名非退伍军人,根据年龄、性别、开始日期和治疗持续时间进行匹配。使用临床医生管理的PTSD量表-5(CAPS-5)在治疗前后对参与者进行评估。使用贝叶斯重复测量方差分析对CAPS-5分数随时间和组间的差异进行建模。我们进行了贝叶斯模型平均,以基于治疗反应,使用排除贝叶斯因子()量化组间PTSD症状变化的差异。退伍军人和非退伍军人的PTSD症状在治疗前后均有所减轻(科恩d值分别为2.17和1.54)。此外,我们发现有中等证据表明两组之间(=4.8)或两组随时间变化(=4.9)的CAPS-5分数没有差异。尽管根据可靠变化指数,显示改善的退伍军人比例高于非退伍军人(分别为83.7%和74.4%),但两组在治疗后诊断状态的丧失方面没有差异(退伍军人为74.4%,非退伍军人为76.7%)。这项研究提供了证据,表明患有与战争相关PTSD的退伍军人可以从简短的强化创伤聚焦治疗中获益,并且不支持退伍军人在这种情况下需要不同治疗方法的观点。