OBJECTIVE: Posttraumatic stress disorder (PTSD) is a major public health problem that is associated with significant functional impairment. While many patients respond well to treatment, little is known about patterns of improvement, and especially not in residential treatment programs. In this study, we used intensive assessment to investigate early slopes of change in PTSD symptoms in veterans in their first 28 days of residential treatment using the PTSD Checklist. Based on emotional processing theory and the focus on reducing avoidance as a key PTSD treatment target, we hypothesized that avoidance would improve while other symptoms would remain unchanged early in treatment. METHOD: Linear mixed-effects multilevel modeling was used to evaluate linear slopes of symptom change. RESULTS: There was statistically significant improvement on avoidance of internal cues and avoidance of external cues. In contrast, none of the other items assessed (repeated disturbing memories, repeated dreams, flashbacks, physical reactions to trauma memories, hypervigilance, startle) or the total score of the PTSD Checklist changed in 28 days after admission to residential treatment. CONCLUSIONS: These findings show that in this group of veterans with PTSD, reduction in avoidance may precede overall symptom improvement in the first 28 days of residential treatment. Future studies should replicate these findings in other residential settings and in varying treatment modalities to better understand the impact residential treatment programs have on PTSD symptom reduction. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Chou et al. (Mon,) studied this question.