Cognitive behavioral social rhythm group therapy versus present centered group therapy for veterans with posttraumatic stress disorder and major depressive disorder: A randomized controlled pilot trial

Patricia L Haynes; Sarah B Burger; Monica Kelly; Sarah Emert; Suzanne Perkins; M Tracie Shea

doi:10.1016/j.jad.2020.09.009

Cognitive behavioral social rhythm group therapy versus present centered group therapy for veterans with posttraumatic stress disorder and major depressive disorder: A randomized controlled pilot trial

J Affect Disord. 2020 Dec 1:277:800-809. doi: 10.1016/j.jad.2020.09.009. Epub 2020 Sep 7.

Authors

Patricia L Haynes¹, Sarah B Burger², Monica Kelly³, Sarah Emert⁴, Suzanne Perkins⁵, M Tracie Shea⁶

Affiliations

¹ Department of Health Promotion Sciences, University of Arizona, Tucson, USA; Department of Psychiatry, University of Arizona, Tucson, USA; Southern Arizona VA Health Care System, Tucson, USA. Electronic address: thaynes@email.arizona.edu.
² Department of Health Promotion Sciences, University of Arizona, Tucson, USA.
³ Department of Psychiatry, University of Arizona, Tucson, USA; Southern Arizona VA Health Care System, Tucson, USA; Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, USA.
⁴ Department of Psychiatry, University of Arizona, Tucson, USA; Biomedical Research Foundation of Southern Arizona, Tucson, USA; Department of Psychology, University of Alabama, Tuscaloosa, USA.
⁵ Southern Arizona VA Health Care System, Tucson, USA.
⁶ Providence VA Medical Center, Rhode Island, USA; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Rhode Island, USA.

PMID: 33065820
DOI: 10.1016/j.jad.2020.09.009

Abstract

Background: Cognitive Behavioral Social Rhythm Group Therapy (CBSRT) is a chronobiologically-informed group therapy designed to stabilize social rhythms in veterans with comorbid combat-related PTSD and major depressive disorder (MDD). This randomized controlled pilot trial is the first to examine feasibility and preliminary efficacy of group CBSRT as compared to group Present Centered Therapy (PCT), a well-characterized active attention, psychotherapy condition.

Methods: A total of 43 male veterans with combat-related PTSD, MDD, and disruptions in sleep or daily routine were randomly assigned to CBSRT or PCT. Therapy was provided weekly in a group modality for 12 weeks. Follow-up feasibility and gold-standard PTSD, MDD, and subjective/objective sleep assessments were conducted at post-treatment, 3 months, and 6 months post-treatment.

Results: Feasibility results demonstrated that veterans assigned to CBSRT had higher rates of attendance than veterans assigned to PCT. Both CBSRT and PCT were associated with improvements in PTSD and MDD symptoms, sleep efficiency, and number of awakenings; there were no differences between group therapies on these indices. Veterans in the CBSRT group had a greater reduction in the number of nightmares than veterans in the PCT group.

Limitations: Preliminary results must be qualified by the small sample size.

Conclusions: Group CBSRT may be more feasible for veterans than PCT. Both CBSRT and PCT were associated with improvements in psychiatric symptoms with few differences between conditions. CBSRT is a promising new group therapy that may help address the high-rate of PTSD therapy attrition in combat veterans.

Clinical trial registration: NCT00984698.

Keywords: Cognitive behavioral therapy; Depression; PTSD; Sleep; Social rhythms; Veterans.

Publication types

Randomized Controlled Trial
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Depressive Disorder, Major* / therapy
Humans
Male
Pilot Projects
Psychotherapy, Group*
Stress Disorders, Post-Traumatic* / therapy
Treatment Outcome
Veterans*

Associated data

ClinicalTrials.gov/NCT00984698