Ask not for whom the bell tolls: controversy in post-traumatic stress disorder treatment outcome findings for war veterans

Trauma Violence Abuse. 2003 Apr;4(2):112-26. doi: 10.1177/1524838002250763.

Abstract

This article reviews and analyzes two national studies of the efficacy of treatment for war veterans suffering from post-traumatic stress disorder (PTSD). A careful analysis of the studies conducted by the Department of Veterans Affairs (DVA) Northeast Program Evaluation Center (NEPEC) reveals conceptual, methodological, and design flaws in the research, which reports minimal treatment efficacy for PTSD. Based on this limited, if not biased, data, the results were used for policy purposes to dismantle inpatient PTSD hospital units and trauma-focus treatments. A critique is offered as a review to suggest how future studies might be conducted, designed, and evaluated, including the need for independent, "outside" peer reviews inasmuch as the issue of treatment outcomes generalizes to many nonmilitary populations.

Publication types

  • Review

MeSH terms

  • Adaptation, Psychological
  • Humans
  • Outcome and Process Assessment, Health Care*
  • Program Evaluation
  • Psychotherapy* / methods
  • Psychotropic Drugs / therapeutic use*
  • Research Design / standards
  • Research Design / statistics & numerical data*
  • Stress Disorders, Post-Traumatic / drug therapy
  • Stress Disorders, Post-Traumatic / psychology
  • Stress Disorders, Post-Traumatic / rehabilitation
  • Stress Disorders, Post-Traumatic / therapy*
  • United States
  • United States Department of Veterans Affairs
  • United States Public Health Service
  • Veterans / psychology*
  • Vietnam
  • Warfare

Substances

  • Psychotropic Drugs