Posttraumatic stress disorder treatment preference: Prolonged exposure therapy, cognitive processing therapy, or medication therapy?

To investigate preferences for evidence-based treatments for posttraumatic stress disorder (PTSD) and the role of likely PTSD in those preferences. Undergraduate students (N = 119) and participants recruited from trauma support groups (N = 126) read descriptions of front-line recommended treatments for PTSD, including prolonged exposure therapy (PE), cognitive-processing therapy (CPT), and medication therapy (MT). Participants selected their treatment of choice and provided ratings of the credibility and their personal reactions to each treatment. Participants generally preferred psychotherapeutic treatments (CPT and PE) over MT, and this finding persisted when considering likely PTSD. Trauma support group participants and students with no likely PTSD showed preference towards CPT over PE, and students with likely PTSD preferred both CPT and PE over MT. In both groups, credibility and personal reaction ratings were also generally higher for the psychotherapeutic treatments than MT, with the highest ratings of credibility and personal reactions for CPT. There was a significant interaction between treatment type and likely PTSD for credibility and personal reaction ratings among students, such that students with likely PTSD had lower credibility and personal reaction ratings to MT. Determining preference for PTSD treatment has important implications for maximizing treatment efficacy, adherence, and engagement. Our results indicate that individuals generally prefer psychotherapeutic treatments, highlighting the need to increase the availability and utilization of evidence-based psychotherapeutic treatments for PTSD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A Preliminary Examination of the Effects of Pretreatment Relationship Satisfaction on Treatment Outcomes in Cognitive-Behavioral Conjoint Therapy for PTSD.

OBJECTIVE: The primary goal of the present study was to investigate whether pre-treatment relationship satisfaction predicted treatment drop-out and posttraumatic stress disorder (PTSD) symptom outcomes within a trial of cognitive-behavioral conjoint therapy (CBCT) for PTSD (Monson & Fredman, 2012). Additionally, we examined the influence of pre-treatment relationship distress on relationship outcomes. METHOD: Thirty-seven patients and their intimate partners who participated in a course of CBCT for PTSD were assessed for PTSD symptoms with the Clinician-Administered PTSD Scale and PTSD Checklist, and for intimate relationship functioning with the Dyadic Adjustment Scale. CBCT for PTSD is a conjoint therapy designed to improve PTSD symptoms and enhance relationship functioning. Patients had to meet diagnostic criteria for PTSD to be included in the study; however, couples were not required to be in distressed relationships to receive treatment. RESULTS: Neither patients' nor partners' pre-treatment relationship satisfaction, nor their interaction, predicted treatment drop-out (ORs = .97-1.01) or completing patients' post-treatment PTSD symptom severity (sr2 ≤ .03). However, participants who were in distressed relationships prior to treatment made greater gains in relationship satisfaction compared with those who began treatment in more satisfied relationships (g = 1.02). CONCLUSIONS: Among patients receiving CBCT for PTSD, treatment drop-out and improvements in PTSD symptoms may be independent of pre-treatment relationship functioning, whereas improvements in relational functioning may be greater among those distressed prior to treatment.