# Effectiveness of Psychotherapy for Post-Traumatic Stress Disorder in Subjects Suffering from Traumatic Brain Injuries After Motor Vehicle Accidents

## TL;DR

This study finds that both types of psychotherapy help reduce PTSD symptoms in people with and without traumatic brain injuries from car accidents.

## Contribution

The study is among the first to compare trauma-focused and non-trauma-focused psychotherapies for PTSD in individuals with traumatic brain injuries.

## Key findings

- Both trauma-focused and non-trauma-focused psychotherapies equally reduced PTSD symptoms in patients with and without TBIs.
- Earlier treatment initiation improved outcomes for non-TBI patients but not for those with TBIs.
- TBI patients with earlier treatment had lower fluid intelligence scores, indicating possible cognitive impairments.

## Abstract

Background and Objectives: PTSD and traumatic brain injury (TBI) frequently co-occur in survivors of combat exposure, blasts, assaults, or motor vehicle accidents (MVAs), yet the impact of TBI on the psychotherapy outcomes for PTSD, especially in civilians, remains underexplored and frequently underestimated. Methods: This study focused on analysis of the effectiveness of psychotherapies (trauma-focused: prolonged exposure (PE); non-trauma-focused: self-efficacy-focused cognitive therapy (SEF-CT)) in individuals with PTSD, comparing those with and without TBIs. The data of 45 PTSD patients with TBIs were drawn from a clinical trial cohort, with a total of 134 completing treatment. PTSD symptoms were assessed pre- and post-treatment using CAPS-5 and PDS-5. Cognitive functioning was measured via tests of fluid and crystallized intelligence. ANCOVA models examined the level of post-treatment PTSD symptoms with the control of pretreatment symptoms and the effects of TBI, treatment type, gender, age, education, time since the MVA, and level of cognitive functioning. Results: Both psychotherapies were equally effective in reducing PTSD symptoms, regardless of TBI status. The early initiation of treatment predicted better outcomes in non-TBI patients but not in those with TBIs. The TBI participants who began treatment earlier exhibited lower fluid intelligence scores, suggesting mild cognitive impairments that may have moderated the therapy benefits. Conclusions: Patients with PTSD and TBIs can benefit from both trauma-focused and non-trauma-focused CBT. While earlier intervention is beneficial for patients with PTSD alone, cognitive impairments may reduce this advantage in those with TBIs.