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The Emory Treatment Resistance Interview for PTSD-Short Version (E-TRIP-S)
Boadie W Dunlop1,2, Nathaniel L Phillips3, Barbara O Rothbaum1
1Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.
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Objective: Failure to benefit from treatments for posttraumatic stress disorder (PTSD) is common. We previously developed the Emory Treatment Resistance Interview for PTSD (E-TRIP), the first tool to evaluate treatment resistance in PTSD. Here, we provide a simplified version of the scale, the E-TRIP-Short version (E-TRIP-S), that assesses prior responses to first-line evidence-based psychotherapies and medications for PTSD.
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Methods: US military personnel and veterans (N=102) being evaluated for treatment through a specialized academic medical center PTSD clinical program from May 2019 to February 2020 were interviewed by trained assessors. Descriptive statistics of the E-TRIP-S psychotherapy and medication scores were evaluated to provide preliminary evidence regarding the utility of the measure.
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Results: Among those seeking care in an intensive outpatient program for PTSD, the majority of those with prior exposure to evidence-based interventions showed elevated E-TRIP-S scores. Only 11/39 (28.2%) of psychotherapy-treated and 12/52 (23.2%) of medication-treated patients reported that a prior treatment "definitely helped" for their intrusion or avoidance symptoms, indicating limited benefit from previous treatments and providing proof of concept for the measure. One-quarter of those who failed to benefit from one modality (ie, an evidence-based psychotherapy or medication) reported being definitely helped when treated with the alternative modality.
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Conclusion: The E-TRIP-S offers a simplified method for assessing treatment resistance among PTSD patients. Preliminary results suggest that the E-TRIP-S may contribute to clinical care by informing treatment selection for individuals and may support research by identifying treatment-resistant patients for testing new interventions or for stratifying patients based on prior treatment outcomes in clinical trials.
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