Moderators of PTSD symptom change in group cognitive behavioral therapy and group present centered therapy.
Moderators of PTSD symptom change in group cognitive behavioral therapy and group present centered therapy.
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DOI：
10.1016/j.janxdis.2021.102386
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发表时间：
2021-05
影响因子：
10.3
通讯作者：
Sloan DM
中科院分区：
文献类型：
--
作者：
Beck JG;Clapp JD;Unger W;Wattenberg M;Sloan DM
为了研究创伤后应激障碍（PTSD）群体干预过程中变化的调节因子，我们采用多水平模型来评估接受创伤焦点群体认知行为治疗（gCBT, N = 84）或非创伤焦点群体当下中心治疗（gPCT, N = 91）的男性退伍军人的症状群轨迹。在每个干预中对症状群进行单独的模型，检查治疗前PTSD症状、治疗前抑郁严重程度、年龄、创伤指数和结果预期作为潜在的调节因素。gCBT和gPCT的无条件生长模型均显示入侵、回避、负面认知/情绪和唤醒/反应性的减少（均p < 0.001）。每种治疗都出现了不同的恢复调节因子。在高水平的治疗前PTSD症状（低PTSD: p = 0.964, d = 0.05；高PTSD: p < 0.001, d = 1.31），而积极的结果预期增强了认知/情绪的减少（低期望：p = 0.120, d = 0.50；高期望：p < 0.001, d = 1.13）。对于gPCT，高水平的治疗前抑郁症状对侵入性（低抑郁：p < 0.001, d = 0.96；高抑郁：p = 0.376, d = 0.22）和觉醒/反应性（低抑郁：p < 0.001, d = 0.95；高抑郁：p = 0.092, d = 0.39）症状的改变产生负面影响。研究结果支持了检查变化轨迹及其调节因子对特定治疗的重要性，特别是在对比创伤和非创伤治疗时。
To examine moderators of change during group-based intervention for Posttraumatic Stress Disorder (PTSD), multilevel models were used to assess trajectories of symptom clusters in male veterans receiving trauma focused Group Cognitive Behavioral Treatment (gCBT; N = 84) or non-trauma focused Group Present Centered Therapy (gPCT; N = 91). Separate models were conducted for symptom clusters in each intervention, examining pre-treatment PTSD symptoms, pre-treatment depression severity, age, index trauma, and outcome expectancies as potential moderators. Unconditioned growth models for both gCBT and gPCT showed reductions in intrusions, avoidance, negative cognitions/mood, and arousal/reactivity (all p < .001). Distinct moderators of recovery emerged for each treatment. Reductions in avoidance during gCBT were strongest at high levels of pre-treatment PTSD symptoms (low PTSD: p = .964, d = .05; high PTSD: p < .001, d = 1.31) whereas positive outcome expectancies enhanced reductions in cognitions/mood (low Expectancy: p = .120, d = .50; high Expectancy: p < .001, d = 1.13). For gPCT, high levels of pre-treatment depression symptoms negatively impacted change in both intrusion (low depression: p < .001, d = .96; high depression: p = .376, d = .22) and arousal/reactivity (low depression: p < .001, d = .95; high depression: p = .092, d = .39) symptoms. Results support the importance of examining trajectories of change and their moderators for specific treatments, particularly when contrasting trauma focused and non-trauma focused treatments.
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DOI：
10.1037/tra0000473
发表时间：
2020-01-01
影响因子：
6.3
作者：
Asnaani, Anu;Kaczkurkin, Antonia N.;Foa, Edna B.
通讯作者：
Foa, Edna B.
影响因子：
6.6
作者：
Hurlocker, Margo C.;Vidaurri, Desirae N.;Franklin, C. Laurel
通讯作者：
Franklin, C. Laurel
影响因子：
3.6
作者：
Kubany, ES;Haynes, SN;Burns, K
通讯作者：
Burns, K
影响因子：
3.3
作者：
Frost, Nickolas D.;Laska, Kevin M.;Wampold, Bruce E.
通讯作者：
Wampold, Bruce E.
影响因子：
5.9
作者：
Driessen, Ellen;Cuijpers, Pim;Dekker, Jack J. M.
通讯作者：
Dekker, Jack J. M.