Ask not for whom the bell tolls: controversy in post-traumatic stress disorder treatment outcome findings for war veterans

Abstract

This article reviews and analyzes two national studies of the efficacy of treatment for war veterans suffering from post-traumatic stress disorder (PTSD). A careful analysis of the studies conducted by the Department of Veterans Affairs (DVA) Northeast Program Evaluation Center (NEPEC) reveals conceptual, methodological, and design flaws in the research, which reports minimal treatment efficacy for PTSD. Based on this limited, if not biased, data, the results were used for policy purposes to dismantle inpatient PTSD hospital units and trauma-focus treatments. A critique is offered as a review to suggest how future studies might be conducted, designed, and evaluated, including the need for independent, "outside" peer reviews inasmuch as the issue of treatment outcomes generalizes to many nonmilitary populations.