Theoretical and empirical issues in the treatment of post-traumatic stress disorder in Vietnam veterans.

This article reviews the current status of research on the treatment of combat-related post-traumatic stress disorder (PTSD) in Vietnam veterans. Dynamic, behavioral, and biochemical models of treatment are presented, along with the findings of relevant treatment outcome studies. Examination of the treatment procedures employed in available studies revealed that direct therapeutic exposure to the memories of trauma emerged as the PTSD treatment technique common to all three theoretical models. The need for controlled investigations of the clinical efficacy of exposure-based interventions for combat-related PTSD is discussed. In addition, several other issues relevant to PTSD treatment research are presented and discussed, including the potential utility of studying untrained coping behavior in combat veterans; the effects of using heterogeneous subject samples in PTSD treatment research; and issues related to the measurement of treatment outcome.