09/29/2011 05:13 pm ET Updated Nov 29, 2011

Cognitive Behavioral Therapy for PTSD in Military Women

An important recent study assessed posttraumatic stress disorder (PTSD) treatment for female active-duty and veteran military. Events such as the attacks on September 11, 2001, and the ongoing wars in Iraq and Afghanistan have increased attention on PTSD. Lifetime prevalence rates of PTSD among women who have served in the military is especially high.

Most of the research on PTSD treatment in veterans was conducted on male veterans. In general, cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs) are recommended as the primary treatments for PTSD.

A study by Schnurr et. al. used prolonged exposure, a form of CBT that encourages patients to re-experience traumatic events repeatedly in an attempt to decrease their emotional response and to gradually confront safe but fear-evoking traumatic reminders. Prolonged exposure is used to improve emotional and cognitive processing of traumatic events by helping patients "face their fears." For many years, the Department of Veterans Affairs (VA) typically used a present-centered approach. Present-centered therapy focuses on existing life problems as manifestations of PTSD. Schnurr et al compared the efficacy of prolonged exposure therapy to that of present-centered therapy in active-duty and veteran women with PTSD.

The results of this study demonstrated that the women who experienced prolonged-exposure therapy were more likely to achieve total remission. In both groups, self-reported PTSD symptoms, depression, and overall mental health improved. With prolonged exposure therapy, participants also indicated a decrease in anxiety and enhanced quality of life. Prolonged exposure was found to be more effective than present-centered therapy at posttreatment as well as 3 months following treatment.

While present-centered therapy addresses the problems that have manifested as a result of PTSD, prolonged exposure requires patients to confront and emotionally process the root causes of their PTSD. The results of this randomized controlled trial suggest that while both therapies are beneficial, prolonged exposure therapy provides more effective and longer-lasting benefits.

Schnurr, P.P, Friedman, M.J., Engel, C.C., Foa, E.B., Shea, T.M., Chow, B.K., et al. (2007). Cognitive Behavioral Therapy for Posttraumatic Stress Disorder in Women: A Randomized Controlled Trial. Journal of the American Medical Association, 297, 820-830.