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PTSD: Prolonged Exposure Therapy

Foa and colleagues developed Prolonged Exposure, a standardized treatment, 90-minute, weekly therapy procedure for the management of PTSD. It enables a patient to encounter safe but anxiety-inducing events and stressors to solve their overwhelming stress and paranoia and process the terrifying event, which is crucial in treating Symptom severity. Prolonged exposure therapies consist of four main elements: The psycho-education component addresses common trauma responses and a comprehensive therapeutic rationale. Subjective measures of distress are used to self-assess the anxiousness element (SUDs) (Yoder et al., 2012). These components are repeated, extended mental imagery exposure to bad memories accompanied by analysis or dialogue of the experiences, and repeated, extended in vivo tests to circumstances avoided owing to the discomfort. The patient is given homework between appointments, including a fearful but safe distress event pyramid. Imaginal exposure entails supporting patients in clearly imagining their stressful events while constantly recounting them in detail. Patients can listen to audio recordings of their therapy sessions between visits to get more exposure.

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The prolonged exposure approach addresses the problem of PTSD, which is a ubiquitous and frequently debilitating disorder that impacts countless people in the overall population and servicemembers. Most people experiencing tragic involvements experience temporary hitches adapting and handling, but they usually get more robust with experience and care (Eftekhari et al., 2013). Individuals may have PTSD if their symptoms deteriorate, persevere for months or longer, and impede their daily work. It is crucial to get care as early as PTSD symptoms appear to lessen symptoms and enhance function. Yoder’s article on” Prolonged Exposure Therapy for Combat-Related Posttraumatic Stress Disorder: Comparing Outcomes for Veterans of Different Wars” operationalized and measured the issue by gathering members receiving PTSD treatment at a clinic between 2008 and August 2010. The population selected were primarily experts in the clinic; a structured diagnostic finding stated that all subjects had been diagnosed with PTSD. The population entailed 112 Vietnam War veterans, the foremost Persian Gulf Warfare, and Iraq and Afghanistan wars.

The interview in Yoder’s research consisted of completing personality measures (BDI, PCL, demographics form, Life Events Questionnaire). The Clinician offered PTSD Index (CAPS) and a clinical questionnaire interview with the medical team; the Clinician filled out the intake form. NIH-PA Author Letter prepared a report per the information gathered during the investigation and submitted the instance to the full PTSD clinic at a regular staffing meeting. The PTSD Test was used to measure the issue using the Military Version. The PCL-M was a DSM–IV-based 17-item conscience diagnostic of Depressed patients (Yoder et al., 2012). The PCL-M values varied from 17, with elevated doses representing more severe PTSD. Structural consistency and test-retest were demonstrated for the tool. The PCL-M showed strong internal consistency with other PTSD measures. The BDI-II evaluated behavioral symptoms of depression possible in the previous two weeks. The scores ranged from 0 to 63, with increased concentrations indicating more severe depression.

Eftekhari’s article on “Effectiveness of National Implementation of Prolonged Exposure Therapy in Veterans Affairs Car” operationalized and measured the issue by treating victims with the aid of clinicians contributing to the Program and strained from VA amenities throughout the US. This evaluation tested a population of 1931 veterans attended by 804 physicians (Eftekhari et al., 2013). The intervention was tested with a population with a core psychiatric disorder, had given their valid consent, and did not require acute emergency stabilization. As participants arrived for treatment, clinicians recruited them in compliance with their regional clinic policies. They relied on their patient care to decide which patients would be viable targets for PE. Patients must undergo 8 to 15 PE training sessions, per the PE testing standards (Eftekhari et al., 2013). During their initial consultation and every following treatment appointment, patients filled out self-report severity assessments for PTSD. Clinicians received demographic and clinical outcomes measures, but only de-identified results were given to systematic review staff. Individuals who finished eight or more PE programs were designated “completers.”

Eftekhari utilized two self-report symptom assessments, including the PTSD Assessment (PCL) and a 17-item questionnaire comprising the PTSD standards. On a 5-point scale, respondents rated how they perceived each symptom (Eftekhari et al., 2013). A cumulative PCL score varying from 17 was calculated by adding all items. Physicians were advised to employ the PCL-S technique for PE to guarantee that symptoms were anchored to the intended trauma. The validity and logical reliability of the PCL were shown. The BDI-II, which represents a questionnaire self-report assessment of despair, was the next symptom measure. A 4 Likert scale was used to rate the subject. The scale ranged between 0 to 63, with high values indicating more severe depression. Score bands represented minimum, mild, medium, and severe depressive symptoms. The BDI-psychometric II’s qualities were thoroughly reported, and the examination showed strong validity, narrative coherence, and accuracy.

In Yoder’s findings, PTSD symptoms improved significantly in members from all three categories, with soldiers from Afghanistan/Iraq and Vietnam responding equally to treatment. Persian Gulf War experts did not react to therapy simultaneously or to the same extent as warriors of the other two wars. According to Eftekhari’s findings, PE is beneficial in lowering indicators of PTSD and depression with response sizes equivalent to those noted in previous effectiveness trials. On the PTSD Scale, positive patients for PTSD dropped to 46.2 percent (Yoder et al., 2012). The First similarity of the findings in the two articles is that the sum of patients with PTSD signs had decreased in both articles. Participants in Yoder’s research responded equally to treatment, decreasing their number. Contrary, in Eftekhari’s research, the number of PTSD cases decreased by 41.4% (Yoder et al., 2012). The second similarity of the articles is that both articles discovered an improvement after the patients underwent the therapy.

The articles differ in their findings; Yoder’s article discovered fewer therapy impacts in improving the symptoms, and some experts completed the treatment at low rates. Eftekhari’s research found that the treatment, when offered within repetitive VHA surroundings, is related to significant perfection in PTSD symptoms across subcategories of patients (Eftekhari et al., 2013). The number of veterans completing the treatment was high in Eftekhari’s findings. The key takeaway from these articles about how the intervention works to address the social problem is that the exercises work by helping patients to overcome or reduce PTSD symptoms. The therapy relies more profoundly on interactive methods to help people approach upset-related recalls, situations, and sentiments. PE emphases on knowledge to support persons with PTSD halt evading trauma cues.

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Diversity might impact the intervention’s work since it may stimulate stress, worsening the situation. Diversity denotes involving participants from varying social and cultural upbringings and of distinct genders and sexual orientations. Therefore, the PE strategy effectively addresses PTSD challenges since it guides patients on approaching their trauma challenges and situations stressing them. PE reduces PTSD for victims with severe symptoms and positively impacts comorbid conditions.


Eftekhari, A., Ruzek, J. I., Crowley, J. J., Rosen, C. S., Greenbaum, M. A., & Karlin, B. E. (2013). Effectiveness of national implementation of prolonged exposure therapy in Veterans Affairs care. JAMA Psychiatry, 70(9), 949-955. Web.

Yoder, M., Tuerk, P. W., Price, M., Grubaugh, A. L., Strachan, M., Myrick, H., & Acierno, R. (2012). Prolonged exposure therapy for combat-related posttraumatic stress disorder: comparing outcomes for veterans of different wars. Psychological services, 9(1), 16. Web.

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