TY - JOUR
T1 - A personalized index to inform selection of a trauma-focused or non-trauma-focused treatment for PTSD
AU - Stirman, Shannon Wiltsey
AU - Cohen, Zachary D.
AU - Lunney, Carole A.
AU - DeRubeis, Robert J.
AU - Wiley, Joshua F.
AU - Schnurr, Paula P.
N1 - Funding Information:
Author Note: This study was conducted with grant Cooperative Studies Program (CSP) #494 from the VA Cooperative Studies Program and support from the Department of Defense for CSP #494. However, the views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs, the Department of Defense, or any US government agency. Trial registration information for CSP #494: Clinicaltrials.gov Identifier NCT00032617. Zachary D. Cohen and Robert J. DeRubeis are supported in part by a grant from MQ: Transforming mental health MQ14PM_27. The opinions and assertions contained in this article should not be construed as reflecting the views of the sponsors. Data reported were presented at the Annual Meeting of the International Society for Traumatic Stress Studies and the Annual Meeting of the American Psychological Association, August 2018. We extend our thanks to Jiyoung Song and Clara Johnson for their assistance with manuscript preparation.
Funding Information:
? Author Note: This study was conducted with grant Cooperative Studies Program (CSP) #494 from the VA Cooperative Studies Program and support from the Department of Defense for CSP #494. However, the views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs, the Department of Defense, or any US government agency. Trial registration information for CSP #494: Clinicaltrials.gov Identifier NCT00032617. Zachary D. Cohen and Robert J. DeRubeis are supported in part by a grant from MQ: Transforming mental health MQ14PM_27. The opinions and assertions contained in this article should not be construed as reflecting the views of the sponsors. Data reported were presented at the Annual Meeting of the International Society for Traumatic Stress Studies and the Annual Meeting of the American Psychological Association, August 2018. We extend our thanks to Jiyoung Song and Clara Johnson for their assistance with manuscript preparation.
Publisher Copyright:
© 2021
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/7
Y1 - 2021/7
N2 - PTSD treatment guidelines recommend several treatments with extensive empirical support, including Prolonged Exposure (PE), a trauma-focused treatment and Present-Centered Therapy (PCT), a non-trauma-focused therapy. Research to inform treatment selection has yielded inconsistent findings with single prognostic variables that are difficult to integrate into clinical decision-making. We examined whether a combination of prognostic factors can predict different benefits in a trauma-focused vs. a non-trauma-focused psychotherapy. We applied a multi-method variable selection procedure and developed a prognostic index (PI) with a sample of 267 female veterans and active-duty service members (mean age 45; SD = 9.37; 53% White) with current PTSD who began treatment in a randomized clinical trial comparing PE and PCT. We conducted linear regressions predicting outcomes (Clinician-Administered PTSD Scale score) with treatment condition, the PI, and the interaction between the PI and treatment condition. The interaction between treatment type and PI moderated treatment response, moderated post-treatment symptom severity, b = 0.30, SEb = 0.15 [95% CI: 0.01, 0.60], p =.049. For the 64% of participants with the best prognoses, PE resulted in better post-treatment outcomes; for the remainder, there was no difference. Use of a PI may lead to optimized patient outcomes and greater confidence when selecting trauma-focused treatments.
AB - PTSD treatment guidelines recommend several treatments with extensive empirical support, including Prolonged Exposure (PE), a trauma-focused treatment and Present-Centered Therapy (PCT), a non-trauma-focused therapy. Research to inform treatment selection has yielded inconsistent findings with single prognostic variables that are difficult to integrate into clinical decision-making. We examined whether a combination of prognostic factors can predict different benefits in a trauma-focused vs. a non-trauma-focused psychotherapy. We applied a multi-method variable selection procedure and developed a prognostic index (PI) with a sample of 267 female veterans and active-duty service members (mean age 45; SD = 9.37; 53% White) with current PTSD who began treatment in a randomized clinical trial comparing PE and PCT. We conducted linear regressions predicting outcomes (Clinician-Administered PTSD Scale score) with treatment condition, the PI, and the interaction between the PI and treatment condition. The interaction between treatment type and PI moderated treatment response, moderated post-treatment symptom severity, b = 0.30, SEb = 0.15 [95% CI: 0.01, 0.60], p =.049. For the 64% of participants with the best prognoses, PE resulted in better post-treatment outcomes; for the remainder, there was no difference. Use of a PI may lead to optimized patient outcomes and greater confidence when selecting trauma-focused treatments.
KW - Evidence-based psychotherapy
KW - PTSD
KW - Treatment selection
UR - http://www.scopus.com/inward/record.url?scp=85106597316&partnerID=8YFLogxK
U2 - 10.1016/j.brat.2021.103872
DO - 10.1016/j.brat.2021.103872
M3 - Article
C2 - 34051626
AN - SCOPUS:85106597316
SN - 0005-7967
VL - 142
JO - Behaviour Research and Therapy
JF - Behaviour Research and Therapy
M1 - 103872
ER -
