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Does Traumatic Brain Injury Attenuate the Exposure Therapy Process?

Katie A Ragsdale1, Michael A Gramlich1, Deborah C Beidel1

  • 1University of Central Florida.

Behavior Therapy
|June 26, 2018
PubMed
Summary

Exposure therapy effectively treats combat-related posttraumatic stress disorder (PTSD), even with a history of traumatic brain injury (TBI). Veterans with TBI history engage in exposure therapy similarly to those without TBI, showing comparable treatment outcomes.

Keywords:
exposure therapyextinctionhabituationposttraumatic stress disordertraumatic brain injury

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Area of Science:

  • Psychiatry
  • Neuroscience
  • Trauma Studies

Background:

  • Combat-related PTSD is a significant issue for veterans.
  • Traumatic brain injury (TBI) is a common comorbidity in veterans with PTSD.
  • The impact of TBI on exposure therapy efficacy for PTSD is not well understood.

Purpose of the Study:

  • To investigate whether fear extinction processes are altered in veterans with PTSD and a history of TBI.
  • To compare key variables of exposure therapy process between veterans with and without TBI.
  • To determine if TBI history necessitates modifications to exposure therapy for PTSD.

Main Methods:

  • The study compared veterans with combat-related PTSD, with and without comorbid TBI.
  • Key exposure therapy process variables were assessed, including fear activation, session duration, habituation, and extinction rates.
  • Statistical analyses controlled for differences in PTSD symptomatology and executive dysfunction perception.

Main Results:

  • Veterans with and without TBI history showed similar rates of fear activation and habituation during exposure therapy.
  • The length and number of exposure sessions required were comparable between groups.
  • Extinction rates did not differ significantly, and self-perceived executive dysfunction did not impact the exposure process.

Conclusions:

  • Individuals with PTSD and a history of TBI engage in exposure therapy as effectively as those with PTSD alone.
  • TBI history does not appear to attenuate the fear extinction process in exposure therapy for PTSD.
  • Exposure therapy remains a recommended first-line treatment for combat-related PTSD, irrespective of comorbid TBI.