ON THE FRONT LINES AGAINST PTSD
exposure (PE) therapy, which gradu- ally exposes an individual to varying trauma-related sensory cues within a safe environment to reduce the inten- sity of emotional and physiological activation and arousal associated with the traumatic events. Te second is cognitive processing therapy (CPT), which focuses on processing memories of traumatic events but without tar- geted exposure to trauma-related cues.
Both therapies have been used exten- sively and have been shown to be effective in civilian populations. MOMRP’s research into the use of PE and CPT in treating military popula- tions found that both therapies were effective but less so than for civilians.
One challenge of PE therapy is that the standard treatment protocol is 15 weekly 90-minute sessions. It can be very challenging for service members to complete the entire protocol because of job and family obligations, as well as deployments and permanent change- of-station requirements. To address the
challenge of lengthy treatment
protocols, MOMRP funded a study that demonstrated that three weeks of daily PE, for 90 minutes each day, was as effective as 15 weekly sessions, dra- matically shortening recovery time.
Tere is also room for improvement in medications for PTSD. Tere are only two approved by the U.S. Food and Drug Administration for treatment of PTSD, and neither has been evaluated for its efficacy in treating service mem- bers. Both medications were developed to treat depression, are less than 50 percent effective in reducing symptoms of PTSD and have side effects, such as sexual dysfunction, that often cause service members to reject taking them.
NEW PATHS FOR PTSD TREATMENT
Col. Dennis McGurk welcomes attendees to the first Post-Traumatic Stress Disorder State of the Science Summit in Shepherdstown, West Virginia, June 13. The two-day meeting brought together experts to investigate new and current avenues in drug development to fight PTSD and related problems. Only two drugs are FDA-approved to treat PTSD, but their effectiveness is limited and their side effects often result in patients opting not to take the medication. (Photo by Crystal Maynard, U.S. Army Medical Materiel Development Activity Public Affairs)
To address the paucity of approved PTSD medications, USAMRMC hosted a state-of-the-science meeting in June in Shepherdstown, West Virginia. About 130 military leaders, academi- cians, researchers and pharmaceutical industry representatives from the fields of psychiatry, psychology, neurobiol- ogy, biochemistry and the development of psychiatric medication met to dis- cuss the pathophysiology of PTSD, with the goal of identifying new targets for therapeutic medications. Findings included identifying and prioritizing research into seven candidate drugs or compounds to treat PTSD.
MOMRP also funds studies that use
complementary and alternative
medicine approaches to treat PTSD, including meditation, yoga, exercise, acupuncture and canine-assisted ther- apy. In most cases, the interventions would be used in conjunction with
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trauma-focused psychotherapy. If these additional efforts prove effective, many combat-experienced warfighters will be able to return to their units, and ulti- mately readiness will improve.
4. Increasing access to and use of behavioral health care by reducing the stigma associated with PTSD and, more broadly, behavioral health care. Additionally, alternative forms of behavioral health care delivery are under evaluation through multiple research projects addressing the use of telemedicine, mobile applications and the internet.
Research is underway on the devel- opment of new methods for training behavioral health providers in the use of evidence-based interventions, with a focus on web-based learning modali- ties. One promising finding indicates that tele-behavioral health approaches,
Army AL&T Magazine
October-December 2017
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