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Original Research October 1, 2025

The Emory Treatment Resistance Interview for PTSD—Short Version (E-TRIP-S)

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J Clin Psychiatry 2025;86(4):25m15956

Abstract

Objective: Failure to benefit from treatments for posttraumatic stress disorder (PTSD) is common. We previously developed the Emory Treatment Resistance Interview for PTSD (E-TRIP), the first tool to evaluate treatment resistance in PTSD. Here, we provide a simplified version of the scale, the E-TRIP-Short version (E-TRIP-S), that assesses prior responses to first-line evidence-based psychotherapies and medications for PTSD.

Methods: US military personnel and veterans (N=102) being evaluated for treatment through a specialized academic medical center PTSD clinical program from May 2019 to February 2020 were interviewed by trained assessors. Descriptive statistics of the E-TRIP-S psychotherapy and medication scores were evaluated to provide preliminary evidence regarding the utility of the measure.

Results: Among those seeking care in an intensive outpatient program for PTSD, the majority of those with prior exposure to evidence-based interventions showed elevated E-TRIP-S scores. Only 11/39 (28.2%) of psychotherapy-treated and 12/52 (23.2%) of medication-treated patients reported that a prior treatment “definitely helped” for their intrusion or avoidance symptoms, indicating limited benefit from previous treatments and providing proof of concept for the measure. One-quarter of those who failed to benefit from one modality (ie, an evidence-based psychotherapy or medication) reported being definitely helped when treated with the alternative modality.

Conclusion: The E-TRIP-S offers a simplified method for assessing treatment resistance among PTSD patients. Preliminary results suggest that the E-TRIP-S may contribute to clinical care by informing treatment selection for individuals and may support research by identifying treatment-resistant patients for testing new interventions or for stratifying patients based on prior treatment outcomes in clinical trials.

J Clin Psychiatry 2025;86(4):25m15956

Author affiliations are listed at the end of this article.

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