Prolonged exposure in patients with chronic PTSD: predictors of treatment outcome and dropout
Prolonged exposure in patients with chronic PTSD: predictors of treatment outcome and dropout
复制标题
DOI：
10.1016/s0005-7967(01)00024-9
复制
发表时间：
2002-04-01
影响因子：
4.1
通讯作者：
Keijsers, GPJ
中科院分区：
文献类型：
--
作者：
van Minnen, A;Arntz, A;Keijsers, GPJ
本研究调查了两个使用长时间想象暴露治疗的混合创伤 PTSD 患者样本的治疗结果和退出的预测因素。分别对两个样本中可能的预测因素进行了分析，以便在一个样本中复制另一个样本中发现的结果。两组中唯一稳定的发现是，在治疗前表现出更多 PTSD 症状的患者，在治疗后和随访中表现出更多 PTSD 症状。研究发现，苯二氮卓类药物的使用与治疗结果和辍学有关，而饮酒则与辍学有关。人口统计学变量、抑郁和普遍焦虑、性格、创伤特征、愤怒、内疚和羞耻感以及治疗的非特异性变量与治疗结果或退出无关，这否定了人们普遍认为这些因素是暴露疗法禁忌症的信念。结论是，很难使用治疗前变量作为预测治疗结果或退出的强大而可靠的工具。因此，从临床角度来看，根据治疗前的特征将 PTSD 患者排除在长期暴露治疗之外是不合理的。 (C) 2002 Elsevier Science Ltd. 保留所有权利。
The present study investigated predictors of treatment outcome and dropout in two samples of PTSD-patients with mixed traumas treated using prolonged imaginal exposure. Possible predictors were analysed in both samples separately, in order to replicate in one sample findings found in the other. The only stable finding across the two groups was that patients who showed more PTSD-symptoms at pre-treatment, showed more PTSD-symptoms at post-treatment and follow-up. Indications were found that benzodiazepine use was related to both treatment outcome and dropout, and alcohol use to dropout. Demographic variables, depression and general anxiety, personality, trauma characteristics, feelings of anger, guilt, and shame and nonspecific variables regarding therapy were not related to either treatment outcome or dropout, disconfirming generally held beliefs about these factors as contra-indications for exposure therapy. It is concluded that it is difficult to use pre-treatment variables as a powerful and reliable tool for predicting treatment outcome or dropout. Clinically seen, it is therefore argued that exclusion of PTSD-patients from prolonged exposure treatment on the basis of pre-treatment characteristics is not justified. (C) 2002 Elsevier Science Ltd. All rights reserved.