A major disorder affecting veterans in the 21st century is post-traumatic stress disorder or PTSD. Many patients with PTSD never seek effective treatment or do not stay in treatment long enough to receive an effective dose. Effective PTSD treatments include certain types of psychotherapy and medication.
Dr. Sheila Rauch, an investigator in the Atlanta VA Health Care System, conducts research that aims to improve PTSD therapy. Dr. Rauch serves as the Director of Mental Health Research at the VA, and she is Associate Professor of Psychiatry and Behavioral Sciences at Emory University. Her research program examines how PTSD treatment works in the brain and in the body. The goals of her studies include: 1) improving our ability to more accurately identify patients who may respond better to certain treatments, 2) developing treatments that are accessible to more patients, and 3) developing treatments that are more effective. For example, Dr. Rauch recently led and completed a comparative efficacy study on the outcomes of Prolonged Exposure therapy, treatment with the medication (sertraline), or the combination of these therapies in combat Veterans with PTSD. In December 2018, the results of this study were reported in JAMA Psychiatry in an article entitled “Randomized Controlled Trial of Prolonged Exposure, Sertraline and Their Combination in Combat Veterans with PTSD”. This study was the largest PTSD treatment and mechanisms trial to date and the largest head-to-head comparison of the two primary treatments for PTSD in Veterans. This article can be found at: https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2716980.
Dr. Rauch’s innovative research program integrates health services research, treatment outcomes and mechanistic research methods to provide a more complete picture of PTSD treatment and treatment response. Her previous studies have demonstrated efficacy of Prolonged Exposure in Veterans for PTSD symptoms and related issues such as suicidality. In other studies, her work identified novel predictors of PTSD treatment response and clarified mechanisms by which Prolonged Exposure therapy reduced PTSD symptoms. Her studies have also demonstrated that a brief version of Prolonged Exposure can be provided effectively in an integrated Primary Care Mental Health setting producing response rates similar to those found in specialty mental health settings.