Toward a precision medicine treatment model for posttraumatic stress disorder.

Abstract

Multiple evidence-based treatments for posttraumatic stress disorder (PTSD) are available, yet they do not benefit all recipients equally due to partial response, early dropout, and persistent symptoms. Despite this, clinicians and patients lack empirically grounded guidance for selecting among treatment options. This commentary argues for the timeliness and clinical promise of a precision medicine approach to treatment research, going beyond estimations of average treatment effects to model the optimal treatment for a given individual and their context. We outline three scientific priorities for progress toward clinically usable decision models: (a) prioritizing heterogeneity in studying treatment response; (b) accounting for provider-, clinic-, and system-level influences along with the patient's social and material context; and (c) increasing rigor and harmonization in outcome measurement. Advancing these priorities will require coordinated efforts to assemble larger and higher-quality PTSD treatment data sources; we highlight several actionable strategies for doing so. To better address the needs of all trauma survivors, the field must not only develop and study effective treatments but also take cohesive steps to understand how, when, and to whom those treatments are best delivered.