Examining trauma cognition change trajectories among initial PTSD treatment non-optimal responders: a potential avenue to guide subsequent treatment selection.
Examining trauma cognition change trajectories among initial PTSD treatment non-optimal responders: a potential avenue to guide subsequent treatment selection.
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在初始PTSD治疗非最佳应答者中检查创伤认知变化轨迹：指导后续治疗选择的潜在途径
DOI：
10.1080/20008066.2023.2237361
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发表时间：
2023
影响因子：
5
通讯作者：
Kaysen, Debra
中科院分区：
文献类型：
--
作者：
Held, Philip;Splaine, Cailan C.;Smith, Dale L.;Kaysen, Debra
尽管他们的一般有效性，14-50%的人不完全响应循证治疗创伤后应激障碍（PTSD）。虽然消极的创伤后认知（NPC）的变化被认为是一种可能的PTSD治疗机制，但对治疗后继续有症状的个体（非最佳反应者）的NPC变化知之甚少。本研究的目的是检查NPC的变化轨迹的个人谁被确定为非最佳响应强化PTSD治疗。使用一个为期3周的基于认知加工疗法的强化PTSD治疗样本（ITP; N = 243），本研究通过基于组的轨迹建模检查了非最佳应答者中不同NPC变化轨迹的数量，并评估了非最佳应答者NPC变化轨迹成员资格的预测因子。在单独的2周ITP样本（N = 215）中重复分析。在两个非最佳应答者样本中，出现了两个轨迹;无NPC变化组代表在整个治疗期间总体缺乏NPC变化的人群，NPC变化组代表主要在治疗后期发生NPC总体减少的人群。治疗期间PTSD症状严重程度的变化是ITP中治疗非最佳应答者NPC变化轨迹组成员资格的唯一一致预测因素。研究结果表明，非最佳反应者之间的NPC变化是微妙的，可能会为后续的干预选择提供信息，从而为未来的研究提供可检验的假设。在整个强化PTSD治疗过程中，非最佳反应者表现出两种不同的创伤后认知变化轨迹：（1）无变化，（2）缓慢变化。治疗期间PTSD症状严重程度的变化一致地预测了非最佳反应者创伤后负面认知的变化轨迹。需要进一步的研究来探索创伤后认知变化的细微差别如何影响最初非最佳反应者的后续治疗干预。
Despite their general effectiveness, 14-50% of individuals do not fully respond to evidence-based treatments for posttraumatic stress disorder (PTSD). Although changes in negative posttrauma cognitions (NPCs) are considered a likely PTSD treatment mechanism, less is known about how NPCs change among individuals who continue to be symptomatic following treatment (non-optimal responders). The objective of this study was to examine NPC change trajectories among individuals who were determined to be non-optimally responsive to intensive PTSD treatment. Using a 3-week Cognitive Processing Therapy-based intensive PTSD treatment sample (ITP; N = 243), the present study examined the number of distinct NPC change trajectories among non-optimal responders via Group Based Trajectory Modeling and assessed predictors of non-optimal responders’ NPC change trajectory membership. Analyses were replicated in a separate 2-week ITP sample (N = 215). In both non-optimal responder samples, two trajectories emerged; a no NPC change group which represented those with an overall lack of NPC change throughout treatment and an NPC change group which represented those with an overall reduction of NPCs occurring primarily later in treatment. Changes in PTSD symptom severity during treatment was the only consistent predictor of NPC change trajectory group membership among treatment non-optimal responders across ITPs. Findings suggest NPC change among non-optimal responders is nuanced and may inform subsequent intervention selection, resulting in testable hypotheses for future research. Throughout intensive PTSD treatment, non-optimal responders exhibited two distinct negative posttrauma cognition change trajectories: (1) no change, and (2) slow change. Changes in PTSD symptom severity during treatment consistently predicted non-optimal responders’ trajectory of change in negative posttrauma cognitions. Additional research is needed to explore how nuances of negative posttrauma cognition change may inform subsequent treatment intervention in initial non-optimal responders.
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DOI：
10.1037/tra0000258
发表时间：
2017-11
期刊：
Psychological trauma : theory, research, practice and policy
影响因子：
--
作者：
Scher CD;Suvak MK;Resick PA
通讯作者：
Resick PA
影响因子：
4.1
作者：
Resick, Patricia A.;Wachen, Jennifer Schuster;Mintz, Jim
通讯作者：
Mintz, Jim
影响因子：
4.1
作者：
Lee DJ;Marx BP;Thompson-Hollands J;Gallagher MW;Resick PA;Sloan DM
通讯作者：
Sloan DM
影响因子：
--
作者：
Fonzo GA;Federchenco V;Lara A
通讯作者：
Lara A
影响因子：
6.9
作者：
Brown, Lily A.;Clapp, Joshua D.;Foa, Edna B.
通讯作者：
Foa, Edna B.