Cited by 226Posttraumatic Stress Disorder ResearchPsychotherapy Techniques and ApplicationsSleep and related disorders

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Randomized controlled trial of prolonged exposure using imaginal exposure vs. virtual reality exposure in active duty soldiers with deployment-related posttraumatic stress disorder (PTSD).

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Reger, Greg M., Koenen-Woods, Patricia, Zetocha, Kimberlee, Smolenski, Derek J., Holloway, Kevin M., Rothbaum, Barbara O., Difede, JoAnn, Rizzo, Albert A., Edwards-Stewart, Amanda, Skopp, Nancy A., Mishkind, Matthew, Reger, Mark A., Gahm, Gregory A.·2016·Journal of Consulting and Clinical Psychology

DOI 10.1037/ccp0000134

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Abstract

OBJECTIVE: Prolonged exposure (PE) is an evidence-based psychotherapy for posttraumatic stress disorder (PTSD) but there is limited research with active-duty military populations. Virtual reality exposure (VRE) has shown promise but randomized trials are needed to evaluate efficacy relative to existing standards of care. This study evaluated the efficacy of VRE and PE for active duty soldiers with PTSD from deployments to Iraq and Afghanistan. METHOD: Active-duty soldiers (N = 162) were randomized to 10-sessions of PE, VRE, or a minimal attention waitlist (WL). Blinded assessors evaluated symptoms at baseline, halfway through treatment, at posttreatment, and at 3- and 6-month follow-ups using the Clinician Administered PTSD Scale (CAPS). RESULTS: Intent-to-treat analyses found that both PE and VRE resulted in significant reductions in PTSD symptoms relative to those in the WL. The majority of patients demonstrated reliable change in PTSD symptoms. There was no difference between PE and VRE regarding treatment drop out before completing 10 sessions (44 and 41% for VRE and PE, respectively). Contrary to hypotheses, analyses at posttreatment did not show that VRE was superior to PE. Post hoc analyses found that PE resulted in significantly greater symptom reductions than VRE at 3- and 6-month follow-up. Both treatments significantly reduced self-reported stigma. CONCLUSIONS: PE is an efficacious treatment for active-duty Army soldiers with PTSD from deployments to Iraq or Afghanistan. Results extend previous evidence supporting the efficacy of PE to active-duty military personnel and raise important questions for future research on VRE. (PsycINFO Database Record

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Authors: Reger, G. M., Koenen-Woods, P., Zetocha, K., Smolenski, D. J., Holloway, K. M., Rothbaum, B. O., Difede, J., Rizzo, A. A., Edwards-Stewart, A., Skopp, N. A., Mishkind, M., Reger, M. A., & Gahm, G. A.
Affiliations: Emory University (US)
Weill Cornell Medicine (US)
University of Southern California (US)
ORCID: Reger, Greg M.
Smolenski, Derek J.
Rothbaum, Barbara O.
Difede, JoAnn
Rizzo, Albert A.
Skopp, Nancy A.
Mishkind, Matthew
Reger, Mark A.
Venue: Journal of Consulting and Clinical Psychology
Publisher: American Psychological Association (APA)
Published: 2016-11
Volume: 84
Issue: 11
Pages: 946-959
ISSN: 0022-006X (ISSN-L)
1939-2117
DOI: 10.1037/ccp0000134
OpenAlex: W2517202283
Cited by: 226
References: 67
Citations by year: 2026: 16 · 2025: 13 · 2024: 20 · 2023: 21 · 2022: 17 · 2021: 27 · 2020: 28 · 2019: 49 · 2018: 17 · 2017: 17 · 2016: 1
FWCI: 37.45
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: other-oa
www.apa.org/pubs/journals/resources/open-access.aspx (am, 311 d)
Locations: Journal of Consulting and Clinical Psychology (publishedVersion, other-oa)
PubMed (publishedVersion)
Funders: U.S. Army Medical Research and Materiel Command (W81XWH-08-2–0015)
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords: prolonged exposure therapy, virtual reality exposure therapy, post-traumatic stress disorder, active duty military personnel, Iraq and Afghanistan deployment, treatment discontinuation, stigma, Clinician-Administered PTSD Scale
MeSH terms: Adult, Female, Humans, Implosive Therapy, Male, Military Personnel, Stress Disorders, Post-Traumatic, Imagery, Psychotherapy, Young Adult, Virtual Reality Exposure Therapy

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Randomized controlled trial of prolonged exposure using imaginal exposure vs. virtual reality exposure in active duty soldiers with deployment-related posttraumatic stress disorder (PTSD).

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