PTSD Symptoms change in response to a brief intensive trauma-focused treatment programme in non-veterans and veterans with war-related PTSD.

Reij, Kirsten M; de Jongh, Ad; Swens, Ernst Paul; Voorendonk, Eline M

Abstract

Background: Evidence suggests that veterans with post-traumatic stress disorder (PTSD) are less likely to benefit from trauma-focused treatment than are patients with PTSD who have not been exposed to war-related trauma. However, new developments in PTSD treatment that combine several evidence-based trauma-focused therapies within a short time frame may help veterans achieve outcomes similar to those of non-veterans.Objective: In this retrospective cohort study, we examined changes in PTSD symptoms and diagnostic status after treatment between veterans and non-veterans. The treatment consisted of a four- or eight-day intensive trauma-focused treatment programme that integrated prolonged exposure, EMDR therapy, psycho-education, and physical activities.Methods: The sample consisted of 43 veterans and 43 non-veterans, matched based on age, sex, starting date, and duration of treatment. Participants were assessed pre- and post-treatment using the Clinician-Administered PTSD Scale-5 (CAPS-5). The differences in CAPS-5 scores over time and between groups were modelled using Bayesian repeated-measures ANOVA. We performed Bayesian model averaging to quantify the differences in PTSD symptom changes between groups, based on treatment response, using the exclusion Bayes factor (BFEXCL).Results: PTSD symptoms in both veterans and non-veterans decreased between pre- and post-treatment (Cohen's d = 2.17 and 1.54, respectively). Furthermore, we found moderate evidence of no differences in CAPS-5 scores between the groups (BFEXCL = 4.8) or between the groups over time (BFEXCL = 4.9). Although a greater proportion of veterans showed improvement according to the reliable change index than non-veterans (83.7% and 74.4%, respectively), there was no difference between the groups in terms of loss of diagnostic status after treatment (74.4% for veterans and 76.7% for non-veterans).Conclusion: This study provides evidence that veterans with war-related PTSD can benefit from brief intensive, trauma-focused treatment and does not support the notion that veterans need a different treatment approach in such settings.

• Journal Article Type: Article
• Acceptance Date: May 21, 2025
• Publication Date: Jun 19, 2025
• Deposit Date: Jul 22, 2025
• Publicly Available Date: Jul 22, 2025
• Journal: European journal of psychotraumatology
• Electronic ISSN: 2000-8066
• Publisher: Taylor & Francis Open
• Peer Reviewed: Peer Reviewed
• Volume: 16
• Issue: 1
• Pages: 2511571
• DOI: https://doi.org/10.1080/20008066.2025.2511571
• Keywords: Bayesian analysis, Veterans, Post-traumatic Stress Disorder, Análisis Bayesiano, Trastorno De Estrés Postraumático, War-related Trauma, Veteranos, Intensive Trauma-focused Treatment, Tratamiento Intensivo Focalizado En Trauma, No Veteranos, Non-veterans, Trauma Relacionado Con La Guerra, Humans, Treatment Outcome, Retrospective Studies, Stress Disorders, Post-Traumatic, Adult, Middle Aged, Female, Male
• PMID: 40536014