scholarly journals Predictors of differential PTSD treatment outcomes between veteran and civilian women after cognitive processing therapy.

2018 ◽  
Vol 10 (2) ◽  
pp. 173-182 ◽  
Author(s):  
Robyn L. Gobin ◽  
Margaret-Anne Mackintosh ◽  
Emy Willis ◽  
Carolyn B. Allard ◽  
Karen Kloezeman ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Cognitive Processing ◽  
Cognitive Processing Therapy ◽  
Ptsd Treatment ◽  
Civilian Women

scholarly journals 4065 Preferences, Expectancies, and Stigma among Treatment Seeking Combat PTSD Patients

2020 ◽  
Vol 4 (s1) ◽  
pp. 34-35
Author(s):  
John Moring ◽  
Alan Peterson ◽  
Casey Straud ◽  
Jim Mintz ◽  
Paul Nabity ◽  
...  
Keyword(s):  
Mental Health ◽  
Patient Satisfaction ◽  
Treatment Outcomes ◽  
Cognitive Processing ◽  
Active Duty ◽  
Service Members ◽  
Cognitive Processing Therapy ◽  
Mental Health Stigma ◽  
Ptsd Treatment ◽  
Opt Out

OBJECTIVES/GOALS: Cognitive Processing Therapy (CPT) is a cognitive behavioral treatment for posttraumatic stress disorder (PTSD). CPT is effective in treating combat-related PTSD among Veterans and active duty service members. It is unknown whether improvement in PTSD is related to accommodation of patient preference of the modality of therapy, such as in-office, telehealth, and in-home settings. An equipoise-stratified randomization design allows for complete randomization of participants who are interested and eligible for all three treatment arms. It also allows participants to reject one treatment arm if they are not interested or eligible. Participants who elect to opt out of one arm are randomized to one of the two remaining treatment arms. The primary aim of this study was to evaluate differences in patient satisfaction, treatment stigma beliefs, and credibility beliefs based on patient treatment modality preference. The second aim of this study was to examine if baseline satisfaction, stigma beliefs, and credibility beliefs predicted PTSD treatment outcomes. METHODS/STUDY POPULATION: Active duty service members and veterans with PTSD (N = 123) were randomized to one of three arms using an equipoise stratified randomization. Participants underwent diagnostic interviews for PTSD at baseline and post-treatment and completed self-report measures of satisfaction, stigma, credibility and expectancies of therapy. RESULTS/ANTICIPATED RESULTS: A series of ANOVAs indicated that there were group differences on patient stigma beliefs regarding mental health, F = 5.61, p = .001, and therapist credibility, F = 5.11, p = .002. Post hoc analyses revealed that participants who did not opt of any treatment arm demonstrated lower levels of stigma beliefs compared to participants who opted-out of in-office, p = .001. Participants who opted out of in-home viewed the therapist as less credible compared to participants who did not opt of any arm, p = .004. Multiple regression analysis found that baseline patient satisfaction, stigma beliefs, and credibility beliefs were not predictive of PTSD treatment outcomes, p > .05. DISCUSSION/SIGNIFICANCE OF IMPACT: Combat PTSD patients may opt out of in-office therapy due to mental health stigma beliefs, and visibility in mental health clinics may be a concern. For patients who opted out of in-home therapy, lack of credibility may have decreased participants’ desire for therapists to enter their home. Despite concerns of mental health stigma and the credibility of the therapy in certain treatment arms, patients in each treatment arm significantly improved in PTSD symptomotology. Moreover, patient characteristics, including satisfaction, stigma, and credibility of the therapy, did not significantly predict treatment outcomes, which demonstrates the robustness of Cognitive Processing Therapy.

Predictors of change in cognitive processing therapy for veterans in a residential PTSD treatment program

2018 ◽  
Vol 75 (3) ◽  
pp. 364-379 ◽  
Author(s):  
Andrew C. Hale ◽  
Jessica L. Rodriguez ◽  
Theodore P. Wright ◽  
Scott A. Driesenga ◽  
C. Richard Spates
Keyword(s):  
Cognitive Processing ◽  
Treatment Program ◽  
Cognitive Processing Therapy ◽  
Ptsd Treatment ◽  
Predictors Of Change

Impact of Self-Blame on Cognitive Processing Therapy: A Comparison of Treatment Outcomes

2018 ◽  
Vol 31 (3) ◽  
pp. 419-426
Author(s):  
Laura E. Stayton ◽  
Benjamin D. Dickstein ◽  
Kathleen M. Chard
Keyword(s):  
Treatment Outcomes ◽  
Cognitive Processing ◽  
Cognitive Processing Therapy ◽  
Self Blame

Comparing PTSD treatment retention among survivors of military sexual trauma utilizing clinical video technology and in-person approaches

2019 ◽  
Vol 26 (7-8) ◽  
pp. 443-451 ◽  
Author(s):  
Lisa M Valentine ◽  
Shannon D Donofry ◽  
Rachel B Broman ◽  
Erin R Smith ◽  
Sheila AM Rauch ◽  
...  
Keyword(s):  
Cognitive Processing ◽  
Sexual Trauma ◽  
Prolonged Exposure ◽  
Cognitive Processing Therapy ◽  
Military Sexual Trauma ◽  
Health Administration ◽  
Video Technology ◽  
Post Traumatic Stress ◽  
Ptsd Treatment ◽  
Delivery Format

Introduction Interventions such as Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) have demonstrated efficacy for the treatment of post-traumatic stress disorder (PTSD) following military sexual trauma (MST). However, MST survivors report a number of logistical and social barriers that impede treatment engagement. In an effort to address these barriers, the Veterans Health Administration offers remote delivery of services using clinical video technology (CVT). Evidence suggests PE and CPT can be delivered effectively via CVT. However, it is unclear whether rates of veteran retention in PTSD treatment for MST delivered remotely is comparable to in-person delivery in standard care. Methods Data were drawn from veterans ( N = 171, 18.1% CVT-enrolled) with PTSD following MST who were engaged in either PE or CPT delivered either via CVT or in person. Veterans chose their preferred treatment modality and delivery format in collaboration with providers. Data were analysed to evaluate full completion (FP) of the protocol and completion of a minimally adequate care (MAC) number of sessions. Results FP treatment completion rates did not differ significantly by treatment delivery format. When evaluating receipt of MAC care, CVT utilizers were significantly less likely to complete. Kaplan–Meier analyses of both survival periods detected significant differences in attrition speed, with the CVT group having higher per-session attrition earlier in treatment. Discussion Disengagement from CVT-delivered treatment generally coincided with early imaginal exposures and writing of trauma narratives. CVT providers may have to take special care to develop rapport and problem-solve anticipated barriers to completion to retain survivors in effective trauma-focused interventions.

scholarly journals Reduced Salience and Enhanced Central Executive Connectivity Following PTSD Treatment

2018 ◽  
Author(s):  
Chadi Abdallah ◽  
Christopher Averill ◽  
Amy Ramage ◽  
Lynnette Averill ◽  
Evelyn Alkin ◽  
...  
Keyword(s):  
Cognitive Processing ◽  
Brain Connectivity ◽  
Secondary Analysis ◽  
Region Of Interest ◽  
Central Executive ◽  
Cognitive Processing Therapy ◽  
Primary Analysis ◽  
Symptom Provocation ◽  
Ptsd Treatment ◽  
Central Executive Network

BACKGROUND: In soldiers with posttraumatic stress disorder (PTSD), symptom provocation was found to induce increased connectivity within the salience network, as measured by functional magnetic resonance imaging (fMRI) and global brain connectivity with global signal regression (GBCr). However, it is unknown whether these GBCr disturbances would normalize following effective PTSD treatment. METHODS: 69 US Army soldiers with (n = 42) and without PTSD (n = 27) completed fMRI at rest and during symptom provocation using subject-specific script imagery. Then, participants with PTSD received 6 weeks (12 sessions) of group cognitive processing therapy (CPT) or present-centered therapy (PCT). At week 8, all participants repeated the fMRI scans. The primary analysis used a region-of-interest approach to determine the effect of treatment on salience GBCr. A secondary analysis was conducted to explore the pattern of GBCr alterations post-treatment in PTSD participants compared to controls. RESULTS: Over the treatment period, PCT significantly reduced salience GBCr (p = .02). Compared to controls, salience GBCr was high pretreatment (PCT, p = .01; CPT, p = .03) and normalized post-PCT (p = .53), but not post-CPT (p = .006). Whole-brain secondary analysis found high GBCr within the central executive network in PTSD participants compared to controls. Post hoc exploratory analyses showed significant increases in executive GBCr following CPT treatment (p = .01). CONCLUSION: The results support previous models relating CPT to central executive network and enhanced cognitive control while unraveling a previously unknown neurobiological mechanism of PCT treatment, demonstrating treatment-specific reduction in salience connectivity during trauma recollection.

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