Research Paper Title

Predictors of attendance and dropout in three randomized controlled trials of PTSD treatment for active duty service members.

Abstract

Dropout from first-line posttraumatic stress disorder (PTSD) treatments is a significant problem.

The researchers reported rates and predictors of attendance and dropout in three clinical trials of evidence-based PTSD treatments in military service members (N = 557).

Service members attended 81.0% of treatment sessions and 30.7% dropped out.

• Individually delivered treatment was associated with greater attendance rates (β = 0.23, p < .001) than group therapy.
• Trauma-focused treatments were associated with higher dropout (β = 0.19, p < .001) than Present-Centred Therapy.
• Age was a significant predictor of session attendance (β = 0.17, p < .001) and drop out (β = -0.23, p < .001).
• History of traumatic brain injury (TBI) predicted lower attendance rates (β = -0.26, p < .001) and greater dropout (β = 0.19, p < .001).

Regardless of treatment type or format, patients who did not drop out were more likely to experience clinically significant gains (d = 0.49, p < .001).

Results demonstrate that dropout from PTSD treatments in these trials was significantly associated with treatment outcome and suggest that strategies are needed to mitigate dropout, particularly in group and trauma-focused therapies, and among younger service members and those with TBI.

Reference

Berke, D.S., Kline, N.K., Wachen, J.S., McLean, C.P., Yarvis, J.S., Mintz, J., Young-McCaughan, S., Peterson, A.L., Foa, E., Resick, P.A., Litz, B.T. & STRONG STAR Consortium. (2019) Predictors of attendance and dropout in three randomized controlled trials of PTSD treatment for active duty service members. Behaviour Research and Therapy. 118, pp.7-17. doi: 10.1016/j.brat.2019.03.003. Epub 2019 Mar 8.