Dropout from prolonged exposure among individuals with posttraumatic stress disorder and comorbid severe mental illness

Wilson J. Brown, Kevin G. Saulnier, Nicholas P. Allan, Jessica A. Wojtalik, Alyssa M. Zampogna, Anouk L. Grubaugh

Research output: Contribution to journalArticlepeer-review


Background: Predictors of dropout in individuals with PTSD and a comorbid severe mental illness (SMI; i.e., schizophrenia, bipolar disorder) have yet to be investigated. As part of a larger randomized controlled trial evaluation of Prolonged Exposure for PTSD plus treatment as usual (PE+TAU) relative to treatment as usual (TAU) alone, the current study examined the following pretreatment predictors of PE dropout in 63 Veterans with PTSD and SMI: (1) PTSD symptom severity; (2) SMI symptom severity; (3) emotion regulation; and (4) patient demographic variables. Methods: A one-way ANOVA examined potential differences at pretreatment across predictor variables of interest between treatment completers (n = 29), participants who never initiated treatment (n = 9), and participants who initiated treatment but later discontinued (n = 25). Discrete time survival analysis using a proportional odds Cox ratio was fit to the data to examine treatment dropout. Results: Of the 63 Veterans enrolled in PE+TAU, 50 initiated treatment, and 29 completed PE. Hazard probabilities for dropout were greatest following sessions 1, 3, and 5. There were no significant predictors of dropout. Limitations: The obtained results are sample-specific and may not generalize to Veteran samples from other regions or community samples of individuals with SMI. Additionally, survival analysis cannot account for participants who never initiated treatment (n = 9). Conclusions: Most individuals with SMI who begin PE successfully complete the full course of treatment, but further investigation of variations in baseline characteristics among non-completer subgroups that may moderate PE outcomes is warranted.

Original languageEnglish (US)
Article number100405
JournalJournal of Affective Disorders Reports
StatePublished - Dec 2022

All Science Journal Classification (ASJC) codes

  • Clinical Psychology
  • Psychiatry and Mental health


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