• Gregory K Wolf, Gregory J Mauntel, Tracy Kretzmer, Eric Crawford, Christina Thors, Thad Q Strom, and Rodney D Vanderploeg.
• Mental Health and Behavioral Sciences, James A. Haley Veterans Hospital, Tampa, Florida (Drs Wolf, Mauntel, Kretzmer, Thors, and Vanderploeg); Departments of Psychiatry and Behavioral Neurosciences (Drs Kretzmer and Vanderploeg) and Psychology (Dr Vanderploeg), University of South Florida, Tampa, Florida; Defense and Veterans Brain Injury Center, Tampa, Florida (Dr Vanderploeg); Durham VA Medical Center, VA Mid-Atlantic Region Mental Illness Research, Education and Clinical Center, and Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Dr Crawford); and Department of Veterans Affairs Medical Center, and Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota (Dr Strom).
• J Head Trauma Rehabil. 2018 Mar 1; 33 (2): E53-E63.

ObjectivesTo examine (a) generalization of the effectiveness of prolonged exposure (PE) therapy for posttraumatic stress disorder (PTSD) in improving postconcussive symptoms (PCSs) and other outcomes in military service members and Veterans (VA) with histories of mild to severe traumatic brain injury (TBI), and (b) factors associated with PCS reduction.SettingVA polytrauma medical center.ParticipantsConsecutive referrals for PTSD treatment of Active Duty (n = 17) or Veterans (n = 27) diagnosed with PTSD and TBI (N = 44).Main Outcome MeasuresNeurobehavioral Symptom Inventory, Key Behaviors Change Inventory, Self-Efficacy for Symptom Management, Posttraumatic Stress Disorder Checklist, and Beck Depression Inventory, 2nd edition.DesignPost hoc analysis of archival clinical effectiveness program evaluation data.InterventionsPE for PTSD.ResultsThere were significant improvements on all outcome measures with large effect sizes (Cohen's d ranging from 0.68 to 2.02). Improvement on PCS (Cohen's d = 1.21) was associated with lower levels of VA service-connected disability and PE treatment completion.ConclusionPE treatment-related improvements for participants with comorbid PTSD and TBI generalize from PTSD outcomes to PCS and other TBI-related outcomes. Positive outcomes were independent of TBI severity, treatment setting, or Veteran status, but dependent upon PE treatment completion and lower levels of VA service-connected disability.

26 keywords...

hide…