STRONG STAR and the Consortium to Alleviate PTSD (CAP) Presentation to: San Antonio Combat PTSD Conference, October 18-19, 2017 Presentation by: Patricia A Resick, Ph.D., ABPP “Cognitive Processing Therapy : Secondary Findings from STRONG STAR Studies” Cognitive Processing Therapy : Secondary Findings from STRONG STAR Studies Presenter: Patricia A. Resick, Ph.D., ABPP Duke University Disclaimer: The views expressed in this presentation are solely those of the author(s) and do not reflect an endorsement by or the official policy or position of the U.S. Army, the U.S. Air Force, the Department of Defense, the Department of Veterans Affairs, or the U.S. Government. Funding: Funding for this work was made possible by the U.S. Department of Defense through the U.S. Army Medical Research and Materiel Command, Congressionally Directed Medical Research Programs, Psychological Health and Traumatic Brain Injury Research Program award(s) W81XWH-08-02-0116 (Patricia Resick) W81XWH-08-02-109 (Alan Peterson) and W81XWH-08-02-0114 (Brett Litz) Purposes of the Presentation • To quickly review the two parent studies. • To present unpublished secondary data from these studies. 3 Study 1. Group CPT Compared to Group PCT • 108 active post-deployment service members from Fort Hood were randomized to either group cognitive processing therapy (CPT) or present centered therapy (PCT) in cohorts that ran simultaneously. • Data were collected between 2/11 and 6/13. • Both CPT and PCT improved significantly but change in symptoms for the CPT group had a larger effect size than PCT (d= 1.1 vs. 0.7 and 1.3 vs. 1.0 at one year follow-up. • On PCL, significant interaction between type of treatment and time (difference in slopes ± SE= .40 ± .16, t= 2.55, P= .012, d= 0.4). Resick et al. 2015 JCCP 4 Study 2. Group Versus Individual CPT • 268 post-deployment active service members were randomized to either group or individual CPT (3/12-9/14) • Improvement in PTSD severity at posttreatment was greater when CPT was administered individually compared with the group format • Mean [SE] difference on the PSS-I: −3.7 [1.4]; d = 0.6; P = .006). • Significant improvements were maintained with both formats, with no differences in remission or severity of PTSD at the 6-month follow-up. • Improvements but no differences on depression or suicidal ideation. Resick et al. 2017, JAMA 5 Psychiatry PSS-I Total 30 25 20 l a t o T 15 I - S S P 10 Group x Visit Interaction F=3.98, df=2, 266, p=.020. 5 Pre-Post Change: Group d=.66, Individual d=1.28. 0 Baseline Post-Treatment 6M Follow-Up Group Individual PSS-I and PCL-S 30 62 25 57 Group 52 20 l l a 47 a t t o o T T 42 15 I S Individual - - S L 37 S C P P 10 32 27 5 22 0 17 Baseline Post-Treatment 6M Follow-Up PSSI PSSI PCL-S PCL-S Proportions Improving Significantly (PSS-I) 60% p=.11 p=.001 p<.001 50% 49% 40% 42% 39% 37% 30% 20% 18% 16% 10% 0% Loss of PTSD Clinically Significant Reliable Change Change Index Group Individual Secondary Findings • Traumatic Loss and Grief • Social Support • Hazardous drinking • Insomnia • Anger and aggression (poster session) • Demographic, military, and symptom predictors of treatment outcome. 9 Treating PTSD in Active Duty Service Members with Traumatic Loss: The Mediating Role of Depression Vanessa Jacoby, PhD University of Texas Health Science Center at San Antonio Willie Hale, PhD University of Texas Health Science Center at San Antonio Kirsten Dillon, PhD Duke University Medical Center Kristi Pruiksma, PhD University of Texas Health Science Center at San Antonio Katherine Dondanville, PsyD, University of Texas Health Science Center at San Antonio ABPP Jennifer Schuster Wachen, National Center for PTSD, VA Boston Healthcare System and Boston University School of Medicine PhD COL Jeffrey S. Yarvis, LCSW Carl R. Darnall Army Medical Center, Ft. Hood, Texas Patricia A Resick, PhD, ABPP Duke University Medical Center and the STRONG STAR *STRONG STAR Consortium group authors include (alphabetically): Elizabeth Hembree, PhD, Brett T. Consortium* Litz, PhD, Jim Mintz, PhD, Alan L. Peterson, PhD, ABPP, Stacey Young-McCaughan, PhD