Top Spinal Cord Inj Rehabil. 2026 Spring;32(Suppl 1):162-176. doi: 10.46292/sci25-00124. Epub 2026 Apr 21.
ABSTRACT
BACKGROUND: Spinal cord injury (SCI) increases risk for posttraumatic stress disorder (PTSD). This condition often co-occurs with pain, depression, anxiety, and sleep disturbance, reducing quality of life. Despite the clinical impact of these symptoms, early evidence-based psychological interventions have rarely been evaluated during inpatient rehabilitation. Brief Prolonged Exposure (Brief PE) is a 3-session adaptation of Prolonged Exposure designed to prevent or reduce PTSD.
METHODS: Participants (n = 154, mean age = 50 years, range 18-87; 65% male) with traumatic or nontraumatic SCI were enrolled at a rehabilitation hospital; 148 were randomized to Brief PE (n = 75) or treatment as usual (TAU; n = 73). Brief PE participants received 3 60-minute sessions during their inpatient stay while TAU participants received standard psychosocial care. The primary outcome was PTSD symptom severity (PSSI-5) at baseline, 1, 3, and 6 months. Secondary outcomes included PTSD diagnosis/severity (PSSI-5/PDS-5), pain (NRS-11), depression (PHQ-9), anxiety (GAD-7), sleep disturbance (PROMIS-SD), resilience (CD-RISC-10), and quality of life (SCI-QOL).
RESULTS: PTSD symptoms declined significantly in both groups (P = .003), with no Group × Time effect (P = .33). History of premorbid depression predicted higher PTSD severity (IRR = 1.84, P = .002). At 6 months, PTSD prevalence was lower in Brief PE (5.9%) versus TAU (9.3%), though nonsignificant. Significant Group × Time effects for average and usual pain (P = .032; P = .036) favored Brief PE, with 27% and 33% reductions versus 0% and 5% for TAU. Among Brief PE participants, 96% completed all sessions, with high satisfaction.
CONCLUSION: Brief PE was feasible, acceptable, and produced greater pain reduction than TAU. PTSD symptoms were also lower, though not significantly, suggesting promise for early psychological intervention after SCI.
PMID:42028348 | PMC:PMC13102082 | DOI:10.46292/sci25-00124
