Implementation and Outcome of Combining Interoceptive Exposure With Trauma-Related Exposure Therapy in a Patient With Combat-Related Posttraumatic Stress Disorder

Abstract

Theoretical considerations and several case studies suggest that trauma-related exposure therapy (TRE), which is one of the leading treatments for posttraumatic stress disorder (PTSD), may be augmented by adding interoceptive exposure (IE) therapy. The patient is a retired veteran with chronic PTSD as the primary (most severe) disorder and comorbid major depressive disorder. Treatment consisted of four sessions of IE followed by eight sessions of TRE. Structured interviews and self-report measures of psychopathology are administered pretreatment, midtreatment (after completing IE and before commencing TRE), posttreatment, and at 3-, 6-, and 12-month follow-ups. IE is associated with decreases in PTSD symptoms and anxiety sensitivity. At posttreatment, there are further reductions in PTSD symptoms and several associated symptoms. There are also further gradual improvements over the follow-up assessments. Implications of these findings are discussed, with an emphasis on identifying potential benefits and limitations of using IE+TRE for combat-related PTSD.