scholarly journals Couple Treatment for PTSD: Partner Outcomes and Partner and Patient Influences on Treatment Outcomes

2021 ◽  
Author(s):  
Philippe Shnaider
Keyword(s):  
Treatment Outcomes ◽  
Psychological Functioning ◽  
Controlled Trial ◽  
Future Research ◽  
Ptsd Symptoms ◽  
Symptom Change ◽  
Intimate Partners ◽  
Interpersonal Factors ◽  
Cognitive Behavioural ◽  
Conjoint Therapy

A growing body of literature has documented interpersonal factors associated with the occurrence and treatment of posttraumatic stress disorder (PTSD). Among these factors, intimate partners’ psychological functioning has consistently been found to be associated with patients’ PTSD severity. The present study investigated intimate partners’ psychological functioning outcomes in a sample of 40 partners of individuals with PTSD within a randomized waitlist controlled trial of cognitive-behavioural conjoint therapy for PTSD. In addition, models of influence from partners to patients and vice versa were examined. More specifically, these models investigated the influence of pretreatment functioning and symptom change on treatment outcomes. There were no significant differences between active treatment and waitlist in intimate partners’ psychological functioning at posttreatment. Furthermore, neither partners’ psychological functioning, nor patients’ PTSD symptoms, influenced the others’ treatment outcomes. Findings are discussed with a focus on guiding future research on partners’ psychological functioning in the context of PTSD.

scholarly journals Couple Treatment for PTSD: Partner Outcomes and Partner and Patient Influences on Treatment Outcomes

2021 ◽  
Author(s):  
Philippe Shnaider
Keyword(s):  
Treatment Outcomes ◽  
Psychological Functioning ◽  
Controlled Trial ◽  
Future Research ◽  
Ptsd Symptoms ◽  
Symptom Change ◽  
Intimate Partners ◽  
Interpersonal Factors ◽  
Cognitive Behavioural ◽  
Conjoint Therapy

A growing body of literature has documented interpersonal factors associated with the occurrence and treatment of posttraumatic stress disorder (PTSD). Among these factors, intimate partners’ psychological functioning has consistently been found to be associated with patients’ PTSD severity. The present study investigated intimate partners’ psychological functioning outcomes in a sample of 40 partners of individuals with PTSD within a randomized waitlist controlled trial of cognitive-behavioural conjoint therapy for PTSD. In addition, models of influence from partners to patients and vice versa were examined. More specifically, these models investigated the influence of pretreatment functioning and symptom change on treatment outcomes. There were no significant differences between active treatment and waitlist in intimate partners’ psychological functioning at posttreatment. Furthermore, neither partners’ psychological functioning, nor patients’ PTSD symptoms, influenced the others’ treatment outcomes. Findings are discussed with a focus on guiding future research on partners’ psychological functioning in the context of PTSD.

scholarly journals Personalization of Treatment for Patients with Childhood-Abuse-Related Posttraumatic Stress Disorder

2021 ◽  
Vol 10 (19) ◽  
pp. 4522
Author(s):  
Chris M. Hoeboer ◽  
Danielle A. C. Oprel ◽  
Rianne A. De Kleine ◽  
Brian Schwartz ◽  
Anne-Katharina Deisenhofer ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Treatment Outcomes ◽  
Posttraumatic Stress ◽  
Childhood Abuse ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Controlled Trial ◽  
Skills Training ◽  
Ptsd Symptoms ◽  
Promising Tool

Background: Differences in effectiveness among treatments for posttraumatic stress disorder (PTSD) are typically small. Given the variation between patients in treatment response, personalization offers a new way to improve treatment outcomes. The aim of this study was to identify predictors of psychotherapy outcome in PTSD and to combine these into a personalized advantage index (PAI). Methods: We used data from a recent randomized controlled trial comparing prolonged exposure (PE; n = 48), intensified PE (iPE; n = 51), and skills training (STAIR), followed by PE (n = 50) in 149 patients with childhood-abuse-related PTSD (CA-PTSD). Outcome measures were clinician-assessed and self-reported PTSD symptoms. Predictors were identified in the exposure therapies (PE and iPE) and STAIR+PE separately using random forests and subsequent bootstrap procedures. Next, these predictors were used to calculate PAI and to retrospectively determine optimal and suboptimal treatment in a leave-one-out cross-validation approach. Results: More depressive symptoms, less social support, more axis-1 diagnoses, and higher severity of childhood sexual abuse were predictors of worse treatment outcomes in PE and iPE. More emotion regulation difficulties, lower general health status, and higher baseline PTSD symptoms were predictors of worse treatment outcomes in STAIR+PE. Randomization to optimal treatment based on these predictors resulted in more improvement than suboptimal treatment in clinician assessed (Cohens’ d = 0.55) and self-reported PTSD symptoms (Cohens’ d = 0.47). Conclusion: Personalization based on PAI is a promising tool to improve therapy outcomes in patients with CA-PTSD. Further studies are needed to replicate findings in prospective studies.

scholarly journals Cognitive–behavioral conjoint therapy for PTSD improves various PTSD symptoms and trauma-related cognitions: Results from a randomized controlled trial.

2016 ◽  
Vol 30 (1) ◽  
pp. 157-162 ◽  
Author(s):  
Alexandra Macdonald ◽  
Nicole D. Pukay-Martin ◽  
Anne C. Wagner ◽  
Steffany J. Fredman ◽  
Candice M. Monson
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Cognitive Behavioral ◽  
Ptsd Symptoms ◽  
Randomized Controlled ◽  
Conjoint Therapy

scholarly journals Participant views on involvement in a trial of social recovery cognitive–behavioural therapy

2015 ◽  
Vol 206 (2) ◽  
pp. 122-127 ◽  
Author(s):  
Caitlin Notley ◽  
Rose Christopher ◽  
Joanne Hodgekins ◽  
Rory Byrne ◽  
Paul French ◽  
...  
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Behavioural Therapy ◽  
Future Research ◽  
Structured Interviews ◽  
Client Group ◽  
Cognitive Behavioural ◽  
Randomised Controlled ◽  
Social Recovery

BackgroundThe PRODIGY trial (Prevention of long term social disability amongst young people with emerging psychological difficulties, ISRCTN47998710) is a pilot trial of social recovery cognitive–behavioural therapy (SRCBT).AimsThe PRODIGY qualitative substudy aimed to (a) explore individual experiences of participating in the pilot randomised, controlled trial (recruitment, randomisation, assessment) and initial views of therapy, and (b) to explore perceived benefits of taking part in research v. ethical concerns and potential risks.MethodQualitative investigation using semi-structured interviews with thematic analysis.ResultsAnalysis revealed participant experiences around the key themes of acceptability, disclosure, practicalities, altruism and engagement.ConclusionsParticipants in both trial arms perceived themselves as gaining benefits from being involved in the study, above and beyond the intervention. This has implications for the design of future research and services for this client group, highlighting the importance of being flexible and an individualised approach as key engagement tools.

scholarly journals An open trial of meaning-centered grief therapy: Rationale and preliminary evaluation

2019 ◽  
Vol 17 (1) ◽  
pp. 2-12 ◽  
Author(s):  
Wendy G. Lichtenthal ◽  
Corinne Catarozoli ◽  
Melissa Masterson ◽  
Elizabeth Slivjak ◽  
Elizabeth Schofield ◽  
...  
Keyword(s):  
Posttraumatic Growth ◽  
Psychological Functioning ◽  
Meaning In Life ◽  
Controlled Trial ◽  
Open Trial ◽  
Cognitive Behavioral ◽  
Future Research ◽  
Preliminary Evaluation ◽  
Prolonged Grief ◽  
Grief Therapy

AbstractObjectiveTo determine the preliminary feasibility, acceptability, and effects of Meaning-Centered Grief Therapy (MCGT) for parents who lost a child to cancer.MethodParents who lost a child to cancer and who were between six months and six years after loss and reporting elevated levels of prolonged grief were enrolled in open trials of MCGT, a manualized, one-on-one cognitive-behavioral-existential intervention that used psychoeducation, experiential exercises, and structured discussion to explore themes related to meaning, identity, purpose, and legacy. Parents completed 16 weekly sessions, 60–90 minutes in length, either in person or through videoconferencing. Parents were administered measures of prolonged grief disorder symptoms, meaning in life, and other assessments of psychological adjustment preintervention, mid-intervention, postintervention, and at three months postintervention. Descriptive data from both the in-person and videoconferencing open trial were pooled.ResultEight of 11 (72%) enrolled parents started the MCGT intervention, and six of eight (75%) participants completed all 16 sessions. Participants provided positive feedback about MCGT. Results showed postintervention longitudinal improvements in prolonged grief (d = 1.70), sense of meaning (d = 2.11), depression (d = 0.84), hopelessness (d = 1.01), continuing bonds with their child (d = 1.26), posttraumatic growth (ds = 0.29–1.33), positive affect (d = 0.99), and various health-related quality of life domains (d = 0.46–0.71). Most treatment gains were either maintained or increased at the three-month follow-up assessment.Significance of resultsOverall, preliminary data suggest that this 16-session, manualized cognitive-behavioral-existential intervention is feasible, acceptable, and associated with transdiagnostic improvements in psychological functioning among parents who have lost a child to cancer. Future research should examine MCGT with a larger sample in a randomized controlled trial.

Treatment outcomes in group‐based cognitive behavioural therapy for chronic pain: An examination of PTSD symptoms

2020 ◽  
Vol 24 (4) ◽  
pp. 807-817
Author(s):  
Sophia Åkerblom ◽  
Sean Perrin ◽  
Marcelo Rivano Fischer ◽  
Lance M. McCracken
Keyword(s):  
Chronic Pain ◽  
Treatment Outcomes ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Ptsd Symptoms ◽  
Cognitive Behavioural

A Pragmatic Randomized Controlled Trial of Computerized CBT (SPARX) for Symptoms of Depression among Adolescents Excluded from Mainstream Education

2011 ◽  
Vol 40 (5) ◽  
pp. 529-541 ◽  
Author(s):  
Theresa Fleming ◽  
Robyn Dixon ◽  
Christopher Frampton ◽  
Sally Merry
Keyword(s):  
Psychological Functioning ◽  
Adolescent Depression ◽  
Rating Scale ◽  
Controlled Trial ◽  
Depression Scale ◽  
Behavioural Therapy ◽  
Symptoms Of Depression ◽  
Cognitive Behavioural ◽  
Mainstream Education ◽  
Intent To Treat

Background: Adolescents excluded from mainstream education have high mental health needs. The use of computerized Cognitive Behavioural Therapy (cCBT) has not been investigated with this group. Aims: To test the efficacy of the SPARX cCBT programme for symptoms of depression among adolescents in programmes for students excluded or alienated from mainstream education. Method: Adolescents (32; 34% Maori, 38% Pacific Island, 56% male) aged 13–16 with Child Depression Rating Scale Revised (CDRS-R) scores indicating possible through to almost certain depressive disorder were randomized to SPARX to be completed over the following 5 weeks (n = 20) or to waitlist control (n = 12). Assessments were at baseline, 5 weeks and 10 weeks. Those in the wait condition were invited to complete SPARX after the 5 week assessment. Results: Most participants (n = 26, 81%) completed at least 4 levels of SPARX and 22 (69%) completed all 7 levels. Among the 30 (94%) participants who began treatment as randomized and provided 5-week data, significant differences were found between cCBT and wait groups on the CDRS-R (baseline to 5-week mean change –14.7 versus –1.1, p<.001), remission (78% vs. 36%, p = .047) and on the Reynolds Adolescent Depression Scale (–4.6 vs. +3.2 p = .05) but not on other self-rating psychological functioning scales. In intent-to-treat analyses CDRS-R changes and remission remained significant. Gains were maintained at 10-week follow-up. Conclusions: SPARX appears to be a promising treatment for students with symptoms of depression who are in alternative schooling programmes for those excluded from mainstream education.

scholarly journals Treatment Outcomes of Isoniazid-Resistant (Rifampicin Susceptible) Tuberculosis Patients in Uzbekistan, 2017–2018

2021 ◽  
Vol 18 (6) ◽  
pp. 2965
Author(s):  
Zayniddin Sayfutdinov ◽  
Ajay Kumar ◽  
Dilyara Nabirova ◽  
Jamshid Gadoev ◽  
Laziz Turaev ◽  
...  
Keyword(s):  
Sample Size ◽  
Treatment Outcomes ◽  
Controlled Trial ◽  
Treatment Success ◽  
Secondary Analysis ◽  
World Health ◽  
Future Research ◽  
Control Group ◽  
Tuberculosis Patients ◽  
Health Organization

Tuberculosis patients “resistant to isoniazid and susceptible to rifampicin (Hr-TB)” remain neglected, despite a high burden and poor outcomes. The World Health Organization (WHO) recommends a 6 month regimen consisting of levofloxacin, rifampicin, ethambutol, and pyrazinamide (LRZE) to treat Hr-TB. In contrast, Uzbekistan uses a 9 month regimen (LRZE plus a second-line injectable in the first 3 months). We aimed to assess the treatment outcomes of this novel regimen among Hr-TB patients treated in two regions of Uzbekistan (Fergana and Bukhara) in 2017–2018. We conducted a cohort study involving secondary analysis of routine surveillance data. Of 132 Hr-TB patients, 105 (80%) were successfully treated. Death was the predominant unsuccessful outcome (13, 10%) followed by “treatment failure” (10, 8%) and “lost to follow-up” (4, 2%). High treatment success is an indicator of the potential effectiveness of the novel regimen and adds to the limited global evidence on this issue. However, the sample size was small and there was no comparison group. Since the study was conducted in two regions of Uzbekistan only, the findings have limited generalizability. We recommend future research using an adequate sample size and an appropriate study design (randomized controlled trial or prospective cohort with a control group receiving the WHO-recommended regimen).

scholarly journals Predicting Outcome in an Intensive Outpatient PTSD Treatment Program Using Daily Measures

2021 ◽  
Vol 10 (18) ◽  
pp. 4152
Author(s):  
Valentijn V. P. Alting van Geusau ◽  
Jeroen D. Mulder ◽  
Suzy J. M. A. Matthijssen
Keyword(s):  
Treatment Outcome ◽  
Treatment Outcomes ◽  
Treatment Program ◽  
Prolonged Exposure ◽  
Day Treatment ◽  
Future Research ◽  
Ptsd Symptoms ◽  
Duration Of Treatment ◽  
Growth Curve Models ◽  
Entire Duration

It is useful to investigate factors that could predict treatment outcomes for PTSD. The current study aims to investigate the relationship between daily measured PTSD symptoms during an intensive six-day treatment program and overall post-treatment outcomes. The treatment program combines eye movement desensitization with reprocessing and prolonged exposure, as well as physical activity and psychoeducation. It was expected that for the entire duration of treatment, as well as the first half of the treatment, a greater decline in daily PTSD symptoms would be a predictor for a greater decline in PTSD symptoms at a four-week follow-up. Data from 109 PTSD-patients (87.2% female, mean age = 36.9, SD = 11.5) were used. PTSD symptoms were measured with the CAPS-5 and the self-reported PTSD checklist for DSM-5 (PCL-5). Daily PTSD symptoms were measured with an abbreviated version of the PCL-5 (8-item PCL). Latent growth curve models were used to describe changes in daily PTSD symptoms and predict treatment outcome. Results show that a greater decline in daily PTSD symptoms measured by the 8-item PCL predicts better treatment outcome (CAPS-5 and PCL-5), but that a patient’s PTSD symptoms on the first day of treatment has no predictive effect. A decline in PTSD symptoms only during the first half of treatment was also found to predict treatment outcomes. Future research should be focused on replicating the results of the current study.

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