Treatment Adherence in Cognitive Processing Therapy for Combat-Related PTSD With History of Mild TBI
Treatment Adherence in Cognitive Processing Therapy for Combat-Related PTSD With History of Mild TBI
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DOI：
10.1037/a0031525
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发表时间：
2013-02-01
影响因子：
2.7
通讯作者：
Houston, Wes S.
中科院分区：
文献类型：
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作者：
Davis, Jeremy J.;Walter, Kristen H.;Houston, Wes S.
目的：这项回顾性研究调查了有或没有轻度创伤性脑损伤 (mTBI) 病史的持久自由行动 (OEF) 和伊拉克自由行动 (OIF) 退伍军人对与战斗相关的创伤后应激障碍 (PTSD) 的认知处理疗法 (CPT) 的治疗依从性。方法：对连续转诊至 PTSD 门诊的医疗记录进行审查，确定被诊断患有与战斗相关的 PTSD 的退伍军人，并开始接受 CPT 治疗。样本 (N = 136) 根据阳性 (n = 44) 和阴性 (n = 92) mTBI 病史进行分组。比较各组的症状和治疗依从性。结果：各组在抑郁症治疗前测量方面没有差异，但有 mTBI 病史的退伍军人的自我报告和临床医生评估的 PTSD 症状更高。两组治疗完成率均大于61%。 PTSD 组平均参加会议次数为 9.6 次，mTBI/PTSD 组平均参加会议次数为 7.9 次 (p = .05)。意义：鉴于治疗依从性方面缺乏显着的群体差异，这些初步研究结果表明，对于有 PTSD 和 mTBI 病史的 OEF/OIF 退伍军人以及仅患有 PTSD 的退伍军人来说，针对 PTSD 的标准 CPT 可能是一种可耐受的治疗方法。
Objective: This retrospective study examined treatment adherence in Cognitive Processing Therapy (CPT) for combat-related posttraumatic stress disorder (PTSD) in Veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) with and without history of mild traumatic brain injury (mTBI). Method: Medical record review of consecutive referrals to an outpatient PTSD clinic identified veterans diagnosed with combat-related PTSD who began treatment with CPT. The sample (N = 136) was grouped according to positive (n = 44) and negative (n = 92) mTBI history. Groups were compared in terms of presenting symptoms and treatment adherence. Results: The groups were not different on a pretreatment measure of depression, but self-reported and clinician-rated PTSD symptoms were higher in veterans with history of mTBI. The treatment completion rate was greater than 61% in both groups. The number of sessions attended averaged 9.6 for the PTSD group and 7.9 for the mTBI/PTSD group (p = .05). Implications: Given the lack of marked group differences in treatment adherence, these initial findings suggest that standard CPT for PTSD may be a tolerable treatment for OEF/OIF veterans with a history of PTSD and mTBI as well as veterans with PTSD alone.