A preliminary examination of prolonged exposure therapy with Iraq and Afghanistan Veterans with a diagnosis of posttraumatic stress disorder and mild to moderate traumatic brain injury

Objective: Preliminary examination of the effectiveness of prolonged exposure (PE) therapy for the treatment of posttraumatic stress disorder (PTSD) with Operation Enduring Freedom and Operation Iraqi Freedom Veterans who have experienced traumatic brain injury (TBI). Participants: Ten Veterans with a history of mild to moderate TBI and chronic PTSD. Setting: Outpatient Mental Health/PTSD clinics and polytrauma centers at 2 VA medical centers. Measures: Comprehensive evaluation that included clinical interview, neuropsychologic evaluation, and/or neuroimaging; Posttraumatic Stress Disorder Checklist and Beck Depression Inventory-Second Edition. Procedures: Standard implementation of the PE manual was used in all cases with slight adjustments to account for Veterans' residual cognitive deficits. Veterans completed between 8 and 18 sessions. Results: Veterans demonstrated significant reductions in total PTSD and depression symptoms from pre- to posttreatment. Within-group effect sizes were large. Conclusions: These findings suggest that PE can be safely and effectively implemented with Veterans with PTSD, a history of mild to moderate TBI, and current cognitive impairment.