OBJECTIVE Prolonged exposure (PE) therapy is a first-line posttraumatic stress disorder (PTSD) treatment, but the manualized 90-min session format constitutes a barrier to adopting PE in most settings because they use 60-min sessions for scheduling and billing. We examined whether 60-min PE sessions were as effective and efficient as 90-min PE sessions. METHOD In total, 160 active-duty military personnel with PTSD were randomized to 8-15 sessions of 60- or 90-min PE sessions and assessed pre- and posttreatment, and 3- and 6-month posttreatment, using the Clinician Administered PTSD Scale for Diagnostic and Statistical Manual for Mental Disorders, 5th edition [DSM-5] (CAPS-5). Participants were also assessed weekly during treatment using the PTSD Checklist for DSM-5 (PCL-5). A 60-min PE was hypothesized to be noninferior to 90-min PE based on preliminary studies. RESULTS Using intent-to-treat analyses, the 95% CI for the difference between 60- and 90-min PE was less than the noninferiority margin (4.69 for the CAPS-5 and 7.38 for the PCL-5) at all three endpoints, suggesting that the efficacy of 60-min PE was noninferior to that of 90-min PE. Similarly, the rate of improvement per session for 60-min PE was noninferior to the rate for 90-min sessions for the PCL-5. Sensitivity analyses and Bayes factors were consistent with these results. CONCLUSIONS 60-min sessions of PE are noninferior to 90-min sessions with regard to both efficacy and efficiency. Thus, PE can be effectively delivered in shorter sessions, making it easier for behavioral health providers to implement within the military health system and in other mental health systems that use 60-min session appointments. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

中文翻译：

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90 分钟与 60 分钟长时间接触对 PTSD 的疗效：现役军人的随机对照试验。

目的 长期暴露 (PE) 治疗是创伤后应激障碍 (PTSD) 的一线治疗，但手动 90 分钟疗程的格式构成了在大多数情况下采用 PE 的障碍，因为他们使用 60 分钟的疗程来安排和计费。我们检查了 60 分钟的体育课是否与 90 分钟的体育课一样有效和高效。方法 总共有 160 名患有 PTSD 的现役军人被随机分配到 8-15 次 60 或 90 分钟的体育课，并使用临床医生管理的 PTSD 量表评估治疗前和治疗后以及治疗后 3 个月和 6 个月精神疾病诊断和统计手册，第 5 版 [DSM-5] (CAPS-5)。参与者还在治疗期间每周使用 DSM-5 (PCL-5) 的 PTSD 检查表进行评估。根据初步研究，假设 60 分钟 PE 不劣于 90 分钟 PE。结果 使用意向治疗分析，在所有三个终点，60 分钟和 90 分钟 PE 之间差异的 95% CI 均小于非劣效界值（CAPS-5 为 4.69，PCL-5 为 7.38），表明 60 分钟 PE 的疗效不劣于 90 分钟 PE。同样，60 分钟 PE 每次会话的改善率不低于 PCL-5 的 90 分钟会话率。敏感性分析和贝叶斯因子与这些结果一致。结论 60 分钟的体育课在疗效和效率方面不劣于 90 分钟的课。因此，PE可以在更短的时间内有效地交付，使行为健康提供者更容易在军事健康系统和其他使用 60 分钟会议预约的心理健康系统中实施。（PsycInfo 数据库记录 (c) 2022 APA，保留所有权利）。