Predictors and moderators of treatment outcomes in phase-based treatment and trauma-focused treatments in patients with childhood abuse-related post-traumatic stress disorder.

Publisher: Taylor & Francis Country of Publication: United States NLM ID: 101559025 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2000-8066 (Electronic) Linking ISSN: 20008066 NLM ISO Abbreviation: Eur J Psychotraumatol Subsets: MEDLINE

Publication: 2016- : Philadelphia, PA : Taylor & Francis
Original Publication: [Järfälla] : [Amsterdam] : Co-action Pub. ; The European Society for Traumatic Stress Studies, [2010]-

Stress Disorders, Post-Traumatic*/diagnosis ; Child Abuse*/therapy ; Eye Movement Desensitization Reprocessing*/methods; Humans ; Child ; Treatment Outcome ; Comorbidity

Background: Knowledge of treatment predictors and moderators is important for improving the effectiveness of treatment for PTSD due to childhood abuse. Objective: The first aim of this study was to test the potential predictive value of variables commonly associated with PTSD resulting from a history of repeated childhood abuse, in relation to treatment outcomes. The second aim was to examine if complex PTSD symptoms act as potential moderators between treatment conditions and outcomes. Method: Data were obtained from a randomized controlled trial comparing a phase-based treatment (Skills Training in Affect and Interpersonal Regulation [STAIR] followed by Eye Movement Desensitization and Reprocessing [EMDR] therapy; n  = 57) with a direct trauma-focused treatment (EMDR therapy only; n  = 64) in people with PTSD due to childhood abuse. The possible predictive effects of the presence of borderline personality disorder, dissociative symptoms, and suicidal and self-injurious behaviours were examined. In addition, it was determined whether symptoms of emotion regulation difficulties, self-esteem, and interpersonal problems moderated the relation between the treatment condition and PTSD post-treatment, corrected for pre-treatment PTSD severity. Results: Pre-treatment PTSD severity proved to be a significant predictor of less profitable PTSD treatment outcomes. The same was true for the severity of dissociative symptoms, but only post-treatment, and not when corrected for false positives. Complex PTSD symptoms did not moderate the relationship between the treatment conditions and PTSD treatment outcomes. Conclusions: The current findings suggest that regardless of the common comorbid symptoms studied, immediate trauma-focused treatment is a safe and effective option for individuals with childhood-related PTSD. However, individuals experiencing severe symptoms of PTSD may benefit from additional treatment sessions or the addition of other evidence-based PTSD treatment approaches. The predictive influence of dissociative sequelae needs further research.The study design was registered in The Dutch trial register (https://www.trialregister.nl/trialreg/admin/rctview.asp?TC = 5991) NTR5991 and was approved by the medical ethics committee of Twente NL 56641.044.16 CCMO.

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Keywords: PTSD; TEPT; abuso infantil; childhood abuse; moderadores; moderators; predictores; predictors; tratamiento; treatment
Local Abstract: [plain-language-summary] One of first studies that aimed to identify multiple potential predictors and moderators in patients with PTSD related to childhood abuse.Only severe PTSD predicted worse treatment outcomes.The predictive influence of dissociative sequelae needs further research.

Date Created: 20240117 Date Completed: 20240118 Latest Revision: 20240121

20240121

PMC10795775

10.1080/20008066.2023.2300589

38230608