Trial Outcomes & Findings for Treatment of Older Veterans With Chronic Posttraumatic Stress Disorder (NCT NCT00539279)

NCT ID: NCT00539279

Last Updated: 2015-08-19

Results Overview

The PTSD Checklist is a self-report questionnaire about PTSD symptoms. The version used in this study is called the PCL-S, which denotes a specific traumatic event for subjects to respond to. There are 17 items, each with response categories from 1 to 5. Thus, the total score ranges from 17 to 85. Higher scores reflect higher levels of PTSD symptoms, and a score of 50 or above is commonly interpreted to designate clinically significant PTSD symptoms.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

87 participants

Primary outcome timeframe

Pre-treatment, post-treatment, and 6-month follow-up

Results posted on

2015-08-19

Participant Flow

Participant milestones

Participant milestones
Measure
Prolonged Exposure Therapy (PE)
Prolonged Exposure Therapy (PE): PE is a therapy that aims to reduce PTSD symptoms via a systematic exposure to feared memories (by imaginal exposure - repeated narration about the traumatic memory) and situations (by in vivo exposure - engaging in feared but safe activities or facing feared situations).
Relaxation Training (RT)
Relaxation Training (RT): RT aims to teach relaxation methods in an effort to reduce anxiety. RT includes Progressive Muscle Relaxation, Imagery Rehearsal, and breathing training.
Treatment
STARTED
41
46
Treatment
COMPLETED
30
38
Treatment
NOT COMPLETED
11
8
Post-Treatment Assessment
STARTED
30
38
Post-Treatment Assessment
COMPLETED
18
29
Post-Treatment Assessment
NOT COMPLETED
12
9
6-Month Follow-Up Assessment
STARTED
18
29
6-Month Follow-Up Assessment
COMPLETED
17
22
6-Month Follow-Up Assessment
NOT COMPLETED
1
7

Reasons for withdrawal

Reasons for withdrawal
Measure
Prolonged Exposure Therapy (PE)
Prolonged Exposure Therapy (PE): PE is a therapy that aims to reduce PTSD symptoms via a systematic exposure to feared memories (by imaginal exposure - repeated narration about the traumatic memory) and situations (by in vivo exposure - engaging in feared but safe activities or facing feared situations).
Relaxation Training (RT)
Relaxation Training (RT): RT aims to teach relaxation methods in an effort to reduce anxiety. RT includes Progressive Muscle Relaxation, Imagery Rehearsal, and breathing training.
Treatment
Withdrawal by Subject
10
8
Treatment
Death
1
0
Post-Treatment Assessment
Lost to Follow-up
12
9
6-Month Follow-Up Assessment
Lost to Follow-up
1
7

Baseline Characteristics

Treatment of Older Veterans With Chronic Posttraumatic Stress Disorder

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Prolonged Exposure Therapy (PE)
n=41 Participants
Prolonged Exposure Therapy (PE): PE is a therapy that aims to reduce PTSD symptoms via a systematic exposure to feared memories (by imaginal exposure - repeated narration about the traumatic memory) and situations (by in vivo exposure - engaging in feared but safe activities or facing feared situations).
Relaxation Training (RT)
n=46 Participants
Relaxation Training (RT): RT aims to teach relaxation methods in an effort to reduce anxiety. RT includes Progressive Muscle Relaxation, Imagery Rehearsal, and breathing training.
Total
n=87 Participants
Total of all reporting groups
Age, Continuous
66.51 Years
STANDARD_DEVIATION 6.21 • n=5 Participants
64.44 Years
STANDARD_DEVIATION 4.49 • n=7 Participants
65.54 Years
STANDARD_DEVIATION 5.69 • n=5 Participants
Sex: Female, Male
Female
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Sex: Female, Male
Male
41 Participants
n=5 Participants
46 Participants
n=7 Participants
87 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants
n=5 Participants
5 Participants
n=7 Participants
7 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
39 Participants
n=5 Participants
41 Participants
n=7 Participants
80 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Asian
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
7 Participants
n=5 Participants
4 Participants
n=7 Participants
11 Participants
n=5 Participants
Race (NIH/OMB)
White
31 Participants
n=5 Participants
38 Participants
n=7 Participants
69 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Region of Enrollment
United States
41 participants
n=5 Participants
46 participants
n=7 Participants
87 participants
n=5 Participants
PTSD Checklist (PCL)
57.46 units on a scale
STANDARD_DEVIATION 12.66 • n=5 Participants
59.98 units on a scale
STANDARD_DEVIATION 11.80 • n=7 Participants
58.28 units on a scale
STANDARD_DEVIATION 12.36 • n=5 Participants
Patient Health Questionnaire Depression Subscale (PHQ-9)
12.13 units on a scale
STANDARD_DEVIATION 6.57 • n=5 Participants
15.12 units on a scale
STANDARD_DEVIATION 5.17 • n=7 Participants
13.28 units on a scale
STANDARD_DEVIATION 6.20 • n=5 Participants
Clinician-Administered PTSD Scale Severity Score (CAPS)
66.02 units on a scale
STANDARD_DEVIATION 14.85 • n=5 Participants
72.98 units on a scale
STANDARD_DEVIATION 14.64 • n=7 Participants
67.11 units on a scale
STANDARD_DEVIATION 17.83 • n=5 Participants
Posttraumatic Cognitions Inventory (PTCI)
3.14 units on a scale
STANDARD_DEVIATION 1.07 • n=5 Participants
3.78 units on a scale
STANDARD_DEVIATION 1.07 • n=7 Participants
3.45 units on a scale
STANDARD_DEVIATION 1.13 • n=5 Participants
State-Trait Anxiety Inventory State Scale (STAI-S)
44.46 units on a scale
STANDARD_DEVIATION 5.46 • n=5 Participants
41.67 units on a scale
STANDARD_DEVIATION 6.13 • n=7 Participants
43.08 units on a scale
STANDARD_DEVIATION 5.96 • n=5 Participants
Sheehan Disability Scale (SDS)
18.15 units on a scale
STANDARD_DEVIATION 8.03 • n=5 Participants
18.83 units on a scale
STANDARD_DEVIATION 7.95 • n=7 Participants
18.19 units on a scale
STANDARD_DEVIATION 8.09 • n=5 Participants
Global Neuropsychological Deficits (Standardized, Composite)
.32 standardized units on a scale
STANDARD_DEVIATION .33 • n=5 Participants
.42 standardized units on a scale
STANDARD_DEVIATION .41 • n=7 Participants
.38 standardized units on a scale
STANDARD_DEVIATION .38 • n=5 Participants

PRIMARY outcome

Timeframe: Pre-treatment, post-treatment, and 6-month follow-up

The PTSD Checklist is a self-report questionnaire about PTSD symptoms. The version used in this study is called the PCL-S, which denotes a specific traumatic event for subjects to respond to. There are 17 items, each with response categories from 1 to 5. Thus, the total score ranges from 17 to 85. Higher scores reflect higher levels of PTSD symptoms, and a score of 50 or above is commonly interpreted to designate clinically significant PTSD symptoms.

Outcome measures

Outcome measures
Measure
Prolonged Exposure Therapy (PE)
n=41 Participants
Prolonged Exposure Therapy (PE): PE is a therapy that aims to reduce PTSD symptoms via a systematic exposure to feared memories (by imaginal exposure - repeated narration about the traumatic memory) and situations (by in vivo exposure - engaging in feared but safe activities or facing feared situations).
Relaxation Training (RT)
n=46 Participants
Relaxation Training (RT): RT aims to teach relaxation methods in an effort to reduce anxiety. RT includes Progressive Muscle Relaxation, Imagery Rehearsal, and breathing training.
PTSD Checklist (PCL)
Baseline
57.46 units on a scale
Standard Deviation 12.66
59.98 units on a scale
Standard Deviation 11.80
PTSD Checklist (PCL)
Post-Treatment
47.00 units on a scale
Standard Deviation 18.91
58.06 units on a scale
Standard Deviation 12.31
PTSD Checklist (PCL)
6-Month Follow-Up
58.37 units on a scale
Standard Deviation 13.77
58.31 units on a scale
Standard Deviation 10.88

PRIMARY outcome

Timeframe: Pre-treatment, post-treatment, and 6-month follow-up

The PHQ-9 is a self-report questionnaire about depressive symptoms. There are 9 scored items, each with response categories from 0 (zero) to 3. Thus, the total score ranges from 0 to 27. Higher scores reflect higher levels of depressive symptoms, with interpretation as follows: 0 (zero) No depression 1-4 Minimal depression 5-9 Mild depression 10-14 Moderate depression 15-19 Moderately severe depression 20-27 Severe depression

Outcome measures

Outcome measures
Measure
Prolonged Exposure Therapy (PE)
n=41 Participants
Prolonged Exposure Therapy (PE): PE is a therapy that aims to reduce PTSD symptoms via a systematic exposure to feared memories (by imaginal exposure - repeated narration about the traumatic memory) and situations (by in vivo exposure - engaging in feared but safe activities or facing feared situations).
Relaxation Training (RT)
n=46 Participants
Relaxation Training (RT): RT aims to teach relaxation methods in an effort to reduce anxiety. RT includes Progressive Muscle Relaxation, Imagery Rehearsal, and breathing training.
Patient Health Questionnaire Depression Subscale (PHQ-9)
Baseline
12.13 units on a scale
Standard Deviation 6.57
15.12 units on a scale
Standard Deviation 5.17
Patient Health Questionnaire Depression Subscale (PHQ-9)
Post-Treatment
10.88 units on a scale
Standard Deviation 7.67
14.80 units on a scale
Standard Deviation 5.75
Patient Health Questionnaire Depression Subscale (PHQ-9)
6-Month Follow-Up
13.12 units on a scale
Standard Deviation 6.15
13.92 units on a scale
Standard Deviation 6.42

PRIMARY outcome

Timeframe: Pre-treatment, post-treatment, and 6-month follow-up

The CAPS is a clinician-administered interview about PTSD symptoms. There are 17 scored items for PTSD severity, each with response categories from 0 (zero) to 4 separately for both frequency and severity. Thus, each item can receive a score of 0 (zero) to 8, and the total severity score ranges from 0 to 136. Higher scores reflect higher levels of PTSD symptoms. Scores of 60 or above are generally considered clinically significant, and changes of 10 points or more (e.g., between pre-treatment and post-treatment) are considered clinically significant changes.

Outcome measures

Outcome measures
Measure
Prolonged Exposure Therapy (PE)
n=41 Participants
Prolonged Exposure Therapy (PE): PE is a therapy that aims to reduce PTSD symptoms via a systematic exposure to feared memories (by imaginal exposure - repeated narration about the traumatic memory) and situations (by in vivo exposure - engaging in feared but safe activities or facing feared situations).
Relaxation Training (RT)
n=46 Participants
Relaxation Training (RT): RT aims to teach relaxation methods in an effort to reduce anxiety. RT includes Progressive Muscle Relaxation, Imagery Rehearsal, and breathing training.
Clinician-Administered PTSD Scale Severity Score (CAPS)
Baseline
66.02 units on a scale
Standard Deviation 14.85
72.98 units on a scale
Standard Deviation 14.64
Clinician-Administered PTSD Scale Severity Score (CAPS)
Post-Treatment
48.48 units on a scale
Standard Deviation 24.58
64.45 units on a scale
Standard Deviation 15.32
Clinician-Administered PTSD Scale Severity Score (CAPS)
6-Month Follow-Up
29.16 units on a scale
Standard Deviation 34.20
37.40 units on a scale
Standard Deviation 32.74

SECONDARY outcome

Timeframe: Pre-treatment, post-treatment, and 6-month follow-up

The PTCI is a self-report questionnaire about thoughts following traumatic events. There are 33 scored items, each with response categories from 1 (Totally Disagree) to 7 (Totally Agree), summed to create the total score. Thus, the total score ranges from 7 to 231. Higher scores reflect higher levels of negative cognitions.

Outcome measures

Outcome measures
Measure
Prolonged Exposure Therapy (PE)
n=41 Participants
Prolonged Exposure Therapy (PE): PE is a therapy that aims to reduce PTSD symptoms via a systematic exposure to feared memories (by imaginal exposure - repeated narration about the traumatic memory) and situations (by in vivo exposure - engaging in feared but safe activities or facing feared situations).
Relaxation Training (RT)
n=46 Participants
Relaxation Training (RT): RT aims to teach relaxation methods in an effort to reduce anxiety. RT includes Progressive Muscle Relaxation, Imagery Rehearsal, and breathing training.
Posttraumatic Cognitions Inventory (PTCI)
Baseline
3.14 units on a scale
Standard Deviation 1.07
3.78 units on a scale
Standard Deviation 1.07
Posttraumatic Cognitions Inventory (PTCI)
Post-Treatment
2.80 units on a scale
Standard Deviation 1.08
3.72 units on a scale
Standard Deviation 1.04
Posttraumatic Cognitions Inventory (PTCI)
6-Month Follow-Up
3.44 units on a scale
Standard Deviation 1.09
3.84 units on a scale
Standard Deviation 1.11

SECONDARY outcome

Timeframe: Pre-treatment, post-treatment, and 6-month follow-up

The STAI-S is a self-report questionnaire about state (present state) anxiety. There are 20 scored items, each with response categories from 1 (Not at All) to 4 (Very Much So). Some items (e.g., "I feel calm") are reversed scored so that the total score appropriately reflects state anxiety. Thus, the total score ranges from 20 to 80. Higher scores reflect higher levels of state anxiety.

Outcome measures

Outcome measures
Measure
Prolonged Exposure Therapy (PE)
n=41 Participants
Prolonged Exposure Therapy (PE): PE is a therapy that aims to reduce PTSD symptoms via a systematic exposure to feared memories (by imaginal exposure - repeated narration about the traumatic memory) and situations (by in vivo exposure - engaging in feared but safe activities or facing feared situations).
Relaxation Training (RT)
n=46 Participants
Relaxation Training (RT): RT aims to teach relaxation methods in an effort to reduce anxiety. RT includes Progressive Muscle Relaxation, Imagery Rehearsal, and breathing training.
State-Trait Anxiety Inventory State Scale (STAI-S)
Baseline
44.46 units on a scale
Standard Deviation 5.46
41.67 units on a scale
Standard Deviation 6.13
State-Trait Anxiety Inventory State Scale (STAI-S)
Post-Treatment
42.64 units on a scale
Standard Deviation 5.81
43.75 units on a scale
Standard Deviation 5.10
State-Trait Anxiety Inventory State Scale (STAI-S)
6-Month Follow-Up
43.72 units on a scale
Standard Deviation 5.96
42.63 units on a scale
Standard Deviation 7.07

SECONDARY outcome

Timeframe: Pre-treatment, post-treatment, and 6-month follow-up

The SDS is a self-report questionnaire about functioning. There are 3 scored items (Work/School; Social Life; and Family Life/Home Responsibilities), each with response categories from 0 (zero; Not at All) to 10 (Extremely). Thus, the total score ranges from 0 to 30. Higher scores reflect lower (poorer) levels of functioning.

Outcome measures

Outcome measures
Measure
Prolonged Exposure Therapy (PE)
n=41 Participants
Prolonged Exposure Therapy (PE): PE is a therapy that aims to reduce PTSD symptoms via a systematic exposure to feared memories (by imaginal exposure - repeated narration about the traumatic memory) and situations (by in vivo exposure - engaging in feared but safe activities or facing feared situations).
Relaxation Training (RT)
n=46 Participants
Relaxation Training (RT): RT aims to teach relaxation methods in an effort to reduce anxiety. RT includes Progressive Muscle Relaxation, Imagery Rehearsal, and breathing training.
Sheehan Disability Scale (SDS)
6-Month Follow-Up
21.06 units on a scale
Standard Deviation 7.44
17.71 units on a scale
Standard Deviation 7.10
Sheehan Disability Scale (SDS)
Baseline
18.15 units on a scale
Standard Deviation 8.03
18.83 units on a scale
Standard Deviation 7.95
Sheehan Disability Scale (SDS)
Post-Treatment
15.31 units on a scale
Standard Deviation 8.89
18.77 units on a scale
Standard Deviation 6.85

SECONDARY outcome

Timeframe: Pre-treatment, post-treatment

Among our battery of seven neuropsychological tests, we worked with our neuropsychologist to choose 13 key scales. We used a conversion system to equally weight areas where there were large deficits, even if there were only one or two deficits, to prevent such scores from being minimized among the large range of T scores for the other scales. We converted T scores as follows: \>40 = 0; 35-39 = 1; 30-34 = 2; 25-29 = 3; 20-24 = 4; \< 20 = 5. Higher scores mean a higher global cognitive deficit.

Outcome measures

Outcome measures
Measure
Prolonged Exposure Therapy (PE)
n=41 Participants
Prolonged Exposure Therapy (PE): PE is a therapy that aims to reduce PTSD symptoms via a systematic exposure to feared memories (by imaginal exposure - repeated narration about the traumatic memory) and situations (by in vivo exposure - engaging in feared but safe activities or facing feared situations).
Relaxation Training (RT)
n=46 Participants
Relaxation Training (RT): RT aims to teach relaxation methods in an effort to reduce anxiety. RT includes Progressive Muscle Relaxation, Imagery Rehearsal, and breathing training.
Global Neuropsychological Deficits (Standardized, Composite)
Baseline
.32 standardized units on a scale
Standard Deviation .33
.42 standardized units on a scale
Standard Deviation .41
Global Neuropsychological Deficits (Standardized, Composite)
Post-Treatment
.35 standardized units on a scale
Standard Deviation .42
.40 standardized units on a scale
Standard Deviation .42

Adverse Events

Prolonged Exposure Therapy (PE)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Relaxation Training (RT)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Steven R. Thorp, Ph.D., ABPP

VA San Diego Healthcare System

Phone: (858) 552-8585

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place