Assessing Treatment-Resistant Posttraumatic Stress Disorder: The Emory Treatment Resistance Interview for PTSD (E-TRIP).

• Type of Material: Article
• Authors: Boadie W Dunlop, Emory University; Joanna L. Kaye, Emory University; Cole Youngner, Emory University; Barbara O Rothbaum, Emory University
• Language: English
• Date: 2014
• Publisher: MDPI
• Publication Version: Final Published Version
• Copyright Statement: © 2014 by the authors
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3390/bs4040511
• Title of Journal or Parent Work: Behavioral Sciences
• ISSN: 2076-328X
• Volume: 4
• Issue: 4
• Start Page: 511
• End Page: 527
• Grant/Funding Information: The funding source had no input into the design of the E-TRIP or writing of the manuscript.; This work was supported by two grants from the National Institute of Mental Health: U19MH069056 and 1R01MH70880-01-A2.
• Keywords: antidepressive agents; psychotherapy; treatment outcomes; evidence-based medicine; treatment failure; psychiatric status rating scales
• Research Categories: Health Sciences, Public Health; Psychology, Behavioral

Abstract

Patients with posttraumatic stress disorder (PTSD) who fail to respond to established treatments are at risk for chronic disability and distress. Although treatment-resistant PTSD (TR-PTSD) is a common clinical problem, there is currently no standard method for evaluating previous treatment outcomes. Development of a tool that could quantify the degree of resistance to previously provided treatments would inform research in patients with PTSD. We conducted a systematic review of PTSD treatment trials to identify medication and psychotherapy interventions proven to be efficacious for PTSD. We then developed a semi-structured clinician interview called the Emory Treatment Resistance Interview for PTSD (E-TRIP). The E-TRIP includes clinician-administered questions to assess the adequacy and benefit derived from past treatment trials. For each adequately delivered treatment to which the patient failed to respond, a score is assigned depending on the strength of evidence supporting the treatment's efficacy. The E-TRIP provides a comprehensive assessment of prior PTSD treatments that should prove valuable for researchers studying TR-PTSD and evaluating the efficacy of new treatments for patients with PTSD. The E-TRIP is not intended to guide treatment; rather, the tool quantifies the level of treatment resistance in patients with PTSD in order to standardize TR-PTSD in the research domain.