ABSTRACT
Behavioral and cognitive-behavioral theories and research in the area of combat-related posttraumatic stress disorder (PTSD) are selectively reviewed. Particularly emphasized are models that include mechanisms for conditioning arousal and avoidance, psychophysiological assessment methods, and treatment research focused on arousal management and exposure methods. Research at the Honolulu Veterans Administration Medical Center illustrates recent attempts to evaluate behavioral interventions with male veterans of the Vietnam combat era. Relaxation treatment in the form of muscle potential biofeedback and home practice is described. Preliminary results suggest an impact on psychophysiological and questionnaire measures of arousal, but not on reexperiencing of combat trauma. By contrast, in four case studies, exposure treatment in the form of eye movement desensitization and reprocessing appeared primarily to affect memorable aspects of trauma, but not arousal as assessed psychophysiologically. These results argue for a comprehensive PTSD treatment package that targets multiple dimensions of responding.
