Participant Information: Group Treatment of PTSD Study

Cooperative Study #420

Did you serve in Southeast Asia during the Vietnam War?

Are you still dealing with vivid reminders of it?

If so, you may have Posttraumatic Stress Disorder (PTSD).

This page tells you about PTSD and a study on the treatment of PTSD for male Vietnam veterans. It tells you about what you can expect if you are in the study. It also tells you where you can participate and how to get more information about participating.

Just what is PTSD?

Posttraumatic stress disorder (PTSD) is a serious health problem that can occur due to the emotional shock of events such as war, rape, domestic and community violence, child abuse, life-threatening accidents, natural disasters, or political torture. Not everyone who experiences these highly stressful events develops PTSD, but between one in ten to as many as three-quarters of trauma survivors suffer PTSD at some time. PTSD involves three types of symptoms.

Re-experiencing or "intrusive" symptoms occur when the traumatic event "intrudes" into a person's current life in the form of sudden vivid memories, painful emotions triggered by reminders of the experience, nightmares, or flashbacks in which it seems like the experience is actually happening all over again.

Avoidance symptoms are the second type, including attempts to block or get rid of the re-experiencing symptoms by avoiding thoughts, feelings, activities, places, or people that are reminders of the trauma. Avoidance often results in a general feeling of emotional "numbness" that can make relationships seem empty and activities no longer enjoyable.

Hyperarousal symptoms involve feeling on-edge, irritable or downright angry, unable to concentrate, jumpy, and excessively worried about danger--both while awake and when trying to sleep. War veterans find themselves diving for cover when they hear a car backfire or a string of firecrackers exploding, for example.

PTSD leaves a person feeling tense, tired, and turned-off to life. Feelings of depression, even of suicide, can occur as a result of the strain of living with PTSD. Avoidance can lead a person to become very isolated, or to abuse alcohol or other drugs as an attempt to "self-medicate."

PTSD symptoms can get better, although they may never go away entirely. Seeking and sticking with a treatment program and a support group that deals specifically with PTSD is essential for not only the survivor but also for their family and loved ones.

PTSD can be a severe and chronic long-term disorder that produces functional impairment at home, in the work-place, and in society. PTSD is a documented problem among American veterans of all military conflicts. As a result, the VA has established a very large network of hospital and community-based specialized PTSD treatment programs. Despite the magnitude and expense of these clinical programs, there are not many studies comparing different types of treatment for PTSD. This study will compare two types of group therapy for the treatment of PTSD.

If you enroll in the study, what can you expect?

Group Therapy

This study compares two widely used kinds of group treatments, Trauma Focused Group Therapy and Present Centered Group Therapy. We want to see how the two treatments differ. Trauma Focused Group Therapy will examine participants' experiences while they were in Vietnam, helping participants to regain control over their thoughts and feelings about what they experienced. Present Centered Group Therapy will focus on current life experiences and how the veterans are getting along on a day-to-day basis.

If you participate in the study, you will be randomly assigned to one of the two treatment groups, either Trauma Focus Group Therapy or Present Centered Group Therapy. Both group therapies are designed specifically to treat Vietnam War-related PTSD.

All of the treatment groups will meet for a year. The first 7 months, you will meet weekly for 1 1/2 to 2 hours. After that, you will meet monthly for 5 months and some veterans will receive regular phone calls from their therapists. The treatment is free of charge for those who are eligible.

Case Management

If you enroll in the study, you will be provided a Case Manager to work with you for the whole time you are in the study. The Case Manager will assist assist you with any problems in living that might get in the way of you benefiting from your group therapy treatment as much as possible. You will meet with your case manager once a month. If you have a crisis and need extra help, you can call on your Case Manager to help you get the help you need.

Other Therapy

The treatment protocol for this study is designed to meet the needs of veterans with PTSD. Some veterans may also participate in 12-step groups or self help groups. Some veterans may receive medications for their psychiatric or other medical problems. If a veteran has a emergency during the treatment protocol, other clinical care such as short-term hospitalization may be used.

Informed Consent

You have to decide if you want to participate in the study. You will be given information about the study and explained your rights as a participant. You will be given several days to think about whether or not you want to participate. If you decide you want to participate, you will be asked to sign an informed consent indicating that you understand the conditions of the study and that you wish to participate.

Assessment

Assessment is a necessary part of all research studies. As a participant, you will receive periodic assessments. Before entering the study you will have a thorough assessment to determine your PTSD diagnosis and to determine if you are eligible to participate in the study. During the group therapy, you will fill out brief self-report forms on a monthly basis. You will participate in a more extensive assessment at 7 months, the end of the weekly group therapy sessions, and at 12 months, at the end of the monthly group sessions. Some participants may also be assessed at 18 and 24 months.

Where can you participate in the study?

The TOP (Treatment of PTSD) study is being conducted at the following 10 sites around the US. Each site is located at an inpatient or outpatient Veterans Affairs facility. If you want to see where you could go to participate, look at this table for the VA Center closest to you.

How can you get more information?

If you want more information about the TOP (Treatment of PTSD) study, we can have a staff member from the closest site contact you. You will be contacted by phone, fax, or e-mail. They can explain more about the study and answer any questions you might have about participation. If you want someone to contact you, please click here to submit a request.

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