scholarly journals Predicting Outcome in an Intensive Outpatient PTSD Treatment Program Using Daily Measures

2021 ◽  
Vol 10 (18) ◽  
pp. 4152
Author(s):  
Valentijn V. P. Alting van Geusau ◽  
Jeroen D. Mulder ◽  
Suzy J. M. A. Matthijssen
Keyword(s):  
Treatment Outcome ◽  
Treatment Outcomes ◽  
Treatment Program ◽  
Prolonged Exposure ◽  
Day Treatment ◽  
Future Research ◽  
Ptsd Symptoms ◽  
Duration Of Treatment ◽  
Growth Curve Models ◽  
Entire Duration

It is useful to investigate factors that could predict treatment outcomes for PTSD. The current study aims to investigate the relationship between daily measured PTSD symptoms during an intensive six-day treatment program and overall post-treatment outcomes. The treatment program combines eye movement desensitization with reprocessing and prolonged exposure, as well as physical activity and psychoeducation. It was expected that for the entire duration of treatment, as well as the first half of the treatment, a greater decline in daily PTSD symptoms would be a predictor for a greater decline in PTSD symptoms at a four-week follow-up. Data from 109 PTSD-patients (87.2% female, mean age = 36.9, SD = 11.5) were used. PTSD symptoms were measured with the CAPS-5 and the self-reported PTSD checklist for DSM-5 (PCL-5). Daily PTSD symptoms were measured with an abbreviated version of the PCL-5 (8-item PCL). Latent growth curve models were used to describe changes in daily PTSD symptoms and predict treatment outcome. Results show that a greater decline in daily PTSD symptoms measured by the 8-item PCL predicts better treatment outcome (CAPS-5 and PCL-5), but that a patient’s PTSD symptoms on the first day of treatment has no predictive effect. A decline in PTSD symptoms only during the first half of treatment was also found to predict treatment outcomes. Future research should be focused on replicating the results of the current study.

Patient Memory for Psychological Treatment Contents: Assessment, Intervention, and Future Directions for a Novel Transdiagnostic Mechanism of Change

2019 ◽  
Vol 36 (1) ◽  
pp. 1-11
Author(s):  
Garret G. Zieve ◽  
Lu Dong ◽  
Allison G. Harvey
Keyword(s):  
Treatment Outcome ◽  
Treatment Outcomes ◽  
Psychological Treatment ◽  
Future Research ◽  
Future Directions ◽  
Treatment As Usual ◽  
Support Intervention ◽  
Support Strategies ◽  
Memory Support

AbstractPatient memory for treatment contents is defined as memory for the ideas, concepts, skills, and/or insights (termed treatment points) that the therapist thinks are important for the patient to remember and implement as a part of therapy. This article reviews key findings on patient memory for treatment contents, describes the development and evaluation of the Memory Support Intervention (MSI), and outlines future directions for research. Patient memory for treatment contents is poor, and worse memory is associated with worse treatment outcome. The MSI is composed of eight memory support strategies that therapists incorporate frequently alongside treatment points delivered during treatment-as-usual. Training therapists to deliver the MSI may yield better treatment outcomes by enhancing patient memory for treatment contents. Future research is needed to understand how to best measure patient memory for treatment contents, and the mediators, moderators, and dissemination potential of the MSI.

scholarly journals Couple Treatment for PTSD: Partner Outcomes and Partner and Patient Influences on Treatment Outcomes

2021 ◽  
Author(s):  
Philippe Shnaider
Keyword(s):  
Treatment Outcomes ◽  
Psychological Functioning ◽  
Controlled Trial ◽  
Future Research ◽  
Ptsd Symptoms ◽  
Symptom Change ◽  
Intimate Partners ◽  
Interpersonal Factors ◽  
Cognitive Behavioural ◽  
Conjoint Therapy

A growing body of literature has documented interpersonal factors associated with the occurrence and treatment of posttraumatic stress disorder (PTSD). Among these factors, intimate partners’ psychological functioning has consistently been found to be associated with patients’ PTSD severity. The present study investigated intimate partners’ psychological functioning outcomes in a sample of 40 partners of individuals with PTSD within a randomized waitlist controlled trial of cognitive-behavioural conjoint therapy for PTSD. In addition, models of influence from partners to patients and vice versa were examined. More specifically, these models investigated the influence of pretreatment functioning and symptom change on treatment outcomes. There were no significant differences between active treatment and waitlist in intimate partners’ psychological functioning at posttreatment. Furthermore, neither partners’ psychological functioning, nor patients’ PTSD symptoms, influenced the others’ treatment outcomes. Findings are discussed with a focus on guiding future research on partners’ psychological functioning in the context of PTSD.

scholarly journals Personalization of Treatment for Patients with Childhood-Abuse-Related Posttraumatic Stress Disorder

2021 ◽  
Vol 10 (19) ◽  
pp. 4522
Author(s):  
Chris M. Hoeboer ◽  
Danielle A. C. Oprel ◽  
Rianne A. De Kleine ◽  
Brian Schwartz ◽  
Anne-Katharina Deisenhofer ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Treatment Outcomes ◽  
Posttraumatic Stress ◽  
Childhood Abuse ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Controlled Trial ◽  
Skills Training ◽  
Ptsd Symptoms ◽  
Promising Tool

Background: Differences in effectiveness among treatments for posttraumatic stress disorder (PTSD) are typically small. Given the variation between patients in treatment response, personalization offers a new way to improve treatment outcomes. The aim of this study was to identify predictors of psychotherapy outcome in PTSD and to combine these into a personalized advantage index (PAI). Methods: We used data from a recent randomized controlled trial comparing prolonged exposure (PE; n = 48), intensified PE (iPE; n = 51), and skills training (STAIR), followed by PE (n = 50) in 149 patients with childhood-abuse-related PTSD (CA-PTSD). Outcome measures were clinician-assessed and self-reported PTSD symptoms. Predictors were identified in the exposure therapies (PE and iPE) and STAIR+PE separately using random forests and subsequent bootstrap procedures. Next, these predictors were used to calculate PAI and to retrospectively determine optimal and suboptimal treatment in a leave-one-out cross-validation approach. Results: More depressive symptoms, less social support, more axis-1 diagnoses, and higher severity of childhood sexual abuse were predictors of worse treatment outcomes in PE and iPE. More emotion regulation difficulties, lower general health status, and higher baseline PTSD symptoms were predictors of worse treatment outcomes in STAIR+PE. Randomization to optimal treatment based on these predictors resulted in more improvement than suboptimal treatment in clinician assessed (Cohens’ d = 0.55) and self-reported PTSD symptoms (Cohens’ d = 0.47). Conclusion: Personalization based on PAI is a promising tool to improve therapy outcomes in patients with CA-PTSD. Further studies are needed to replicate findings in prospective studies.

scholarly journals The effect of twice-weekly versus once-weekly sessions of either imagery rescripting or eye movement desensitization and reprocessing for adults with PTSD from childhood trauma (IREM-Freq): a study protocol for an international randomized clinical trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Carlijn J. M. Wibbelink ◽  
Christopher W. Lee ◽  
Nathan Bachrach ◽  
Sarah K. Dominguez ◽  
Thomas Ehring ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Treatment Outcome ◽  
Treatment Outcomes ◽  
Childhood Trauma ◽  
Symptom Severity ◽  
Ptsd Symptom ◽  
Ptsd Symptoms ◽  
Treatment Type ◽  
Imagery Rescripting ◽  
Ptsd Symptom Severity

Abstract Background Trauma-focused treatments for posttraumatic stress disorder (PTSD) are commonly delivered either once or twice a week. Initial evidence suggests that session frequency affects treatment response, but very few trials have investigated the effect of session frequency. The present study’s aim is to compare treatment outcomes of twice-weekly versus once-weekly sessions of two treatments for PTSD related to childhood trauma, imagery rescripting (ImRs) and eye movement desensitization and reprocessing (EMDR). We hypothesize that both treatments will be more effective when delivered twice than once a week. How session frequency impacts treatment response, whether treatment type moderates the frequency effect, and which treatment type and frequency works best for whom will also be investigated. Methods The IREM-Freq trial is an international multicenter randomized clinical trial conducted in mental healthcare centers across Australia, Germany, and the Netherlands. We aim to recruit 220 participants, who will be randomized to one of four conditions: (1) EMDR once a week, (2) EMDR twice a week, (3) ImRs once a week, or (4) ImRs twice a week. Treatment consists of 12 sessions. Data are collected at baseline until one-year follow-up. The primary outcome measure is clinician-rated PTSD symptom severity. Secondary outcome measures include self-reported PTSD symptom severity, complex PTSD symptoms, trauma-related cognitions and emotions, depressive symptoms, dissociation, quality of life, and functioning. Process measures include memory, learning, therapeutic alliance, motivation, reluctance, and avoidance. Additional investigations will focus on predictors of treatment outcome and PTSD severity, change mechanisms of EMDR and ImRs, the role of emotions, cognitions, and memory, the optimization of treatment selection, learned helplessness, perspectives of patients and therapists, the network structure of PTSD symptoms, and sudden treatment gains. Discussion This study will extend our knowledge on trauma-focused treatments for PTSD related to childhood trauma and, more specifically, the importance of session frequency. More insight into the optimal session frequency could lead to improved treatment outcomes and less dropout, and in turn, to a reduction of healthcare costs. Moreover, the additional investigations will broaden our understanding of how the treatments work and variables that affect treatment outcome. Trial registration Netherlands Trial Register NL6965, registered 25/04/2018.

scholarly journals Couple Treatment for PTSD: Partner Outcomes and Partner and Patient Influences on Treatment Outcomes

2021 ◽  
Author(s):  
Philippe Shnaider
Keyword(s):  
Treatment Outcomes ◽  
Psychological Functioning ◽  
Controlled Trial ◽  
Future Research ◽  
Ptsd Symptoms ◽  
Symptom Change ◽  
Intimate Partners ◽  
Interpersonal Factors ◽  
Cognitive Behavioural ◽  
Conjoint Therapy

A growing body of literature has documented interpersonal factors associated with the occurrence and treatment of posttraumatic stress disorder (PTSD). Among these factors, intimate partners’ psychological functioning has consistently been found to be associated with patients’ PTSD severity. The present study investigated intimate partners’ psychological functioning outcomes in a sample of 40 partners of individuals with PTSD within a randomized waitlist controlled trial of cognitive-behavioural conjoint therapy for PTSD. In addition, models of influence from partners to patients and vice versa were examined. More specifically, these models investigated the influence of pretreatment functioning and symptom change on treatment outcomes. There were no significant differences between active treatment and waitlist in intimate partners’ psychological functioning at posttreatment. Furthermore, neither partners’ psychological functioning, nor patients’ PTSD symptoms, influenced the others’ treatment outcomes. Findings are discussed with a focus on guiding future research on partners’ psychological functioning in the context of PTSD.

Effectiveness and Predictors of Outcomes in a Psychiatric Day Treatment Program for Elementary-Age: Children Efficacité et prédicteurs des résultats d’un programme de traitement de jour psychiatrique pour des enfants d’âge primaire

2021 ◽  
pp. 070674372110006
Author(s):  
Sahar Balvardi ◽  
Noriyeh Rahbari ◽  
Alexia Jolicoeur-Martineau ◽  
Lauren Rudy ◽  
Mitchell Arnovitz ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Family Functioning ◽  
Treatment Program ◽  
Externalizing Problems ◽  
Chart Review ◽  
Day Treatment ◽  
Attention Problems ◽  
Developmental Problems ◽  
Rule Breaking ◽  
Day Treatment Program

Objective: In this study, we aimed to (1) assess the effectiveness of an intensive multimodal day treatment program in improving externalizing problems and function in elementary-age children and (2) examine 3 predictors of the treatment outcome (i.e., family functioning, baseline severity, and comorbid disorders). Methods: The sample included 261 children (80.9% boys) between ages of 5 and 12. A retrospective chart review, from 2013 to 2018, and a prospective chart review, from 2018 to 2019, were conducted to extract all relevant data for the present study. Parents and teachers provided reports on children’s externalizing problems (i.e., aggressive behavior, attention problems, and rule-breaking behavior) and their level of function across different domains. The level of family functioning was also reported by parents, while clinicians assessed children’s severity of disturbance and their diagnoses at intake. Results: Based on both parents’ and teachers’ reports, children showed significant improvement in their externalizing problems. Moreover, children showed functional improvement at home, at school, with peers, and in hobbies by the end of the program. Based on teacher’s reports, children with lower level of severity showed less improvement in their attention problems, and those with comorbid developmental problems showed less improvement in their aggressive and rule-breaking behaviors. Family functioning did not predict any treatment outcome. Conclusion: An intensive multimodal day treatment program was effective in reducing the symptoms of externalizing problems in elementary-age children. However, children with less severe difficulties and comorbid developmental problems showed less improvement in their externalizing problems.

Certain difficulties in assessing the effectiveness of a day treatment program for psychiatric outpatients

1970 ◽  
Author(s):  
Joseph W. House ◽  
Marc B. Lipton ◽  
Charles A. Weiss ◽  
Nelson C. Ribble ◽  
Raymond C. Hunt
Keyword(s):  
Treatment Program ◽  
Day Treatment ◽  
Psychiatric Outpatients ◽  
Day Treatment Program

scholarly journals The Psychological Impact of Coronavirus Pandemic Restrictions in Italy. The Mediating Role of the Fear of COVID-19 in the Relationship between Positive and Negative Affect with Positive and Negative Outcomes

2021 ◽  
Vol 11 (3) ◽  
pp. 697-710
Author(s):  
Andrea Zammitti ◽  
Chiara Imbrogliera ◽  
Angela Russo ◽  
Rita Zarbo ◽  
Paola Magnano
Keyword(s):  
Negative Affect ◽  
Psychological Health ◽  
Well Being ◽  
Future Research ◽  
Positive And Negative Affect ◽  
Ptsd Symptoms ◽  
Negative Outcomes ◽  
Event Scale ◽  
Spiritual Well Being ◽  
The Relationship

Italy was quickly hit hard by the coronavirus. ‘Lockdown’ has significantly impacted the psychological health, personal wellbeing and quality of life of the people. The study aims to explore the relationship between positive and negative affect, as well as positive (spiritual well-being and flourishing) and negative outcomes (psychological distress caused by a traumatic life event in terms of perception of PTSD symptoms) on Italian adults during the lockdown period. Data was collected between April and May 2020. The participants were 281 Italian adults aged between 18 and 73 years. The survey was composed of the following measures: Flourishing Scale, Jarel Spiritual Well-Being scale, Positive and Negative Affect Schedule, Impact of Event Scale—Revised, Fear of COVID-19. The mediational analysis shows that fear of COVID-19 fully mediates the relationship between negative affect and spiritual well-being and flourishing; fear of COVID-19 partially mediates the relationship between negative affect and PTSD symptoms; the positive affect shows only direct effects on positive outcomes. Therefore, fear of COVID-19 does not play any mediation role. Implications for psychological interventions and future research will be discussed.

scholarly journals Clinical pattern and predictors of stroke treatment outcome among hospitalised patients who had a stroke at Felege Hiwot comprehensive specialised hospital, northwest Ethiopia: a retrospective cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040238
Author(s):  
Belayneh Kefale ◽  
Amien Ewunetei ◽  
Mulugeta Molla ◽  
Gobezie Temesgen Tegegne ◽  
Amsalu Degu
Keyword(s):  
Treatment Outcome ◽  
Treatment Outcomes ◽  
Medical Records ◽  
Cross Sectional Study ◽  
Northwest Ethiopia ◽  
Cross Sectional ◽  
Stroke Treatment ◽  
Clinical Pattern ◽  
Hospitalised Patients ◽  
Poor Treatment

ObjectivesThis study aimed to assess the clinical pattern and predictors of stroke treatment outcomes among hospitalised patients in Felege Hiwot comprehensive specialised hospital (FHCSH) in northwest Ethiopia.DesignA retrospective cross-sectional study.SettingThe study was conducted medical ward of FHCSH.ParticipantsThe medical records of 597 adult patients who had a stroke were included in the study. All adult (≥18 years) patients who had a stroke had been admitted to the medical ward of FHSCH during 2015–2019 were included in the study. However, patients with incomplete medical records (ie, incomplete treatment regimen and the status of the patients after treatment) were excluded in the study.ResultsIn the present study, 317 (53.1%) were males, and the mean age of the study participants was 61.08±13.76 years. About two-thirds of patients (392, 65.7%) were diagnosed with ischaemic stroke. Regarding clinical pattern, about 203 (34.0%) of patients complained of right-side body weakness and the major comorbid condition identified was hypertension (216, 64.9%). Overall, 276 (46.2%) of them had poor treatment outcomes, and 101 (16.9%) of them died. Patients who cannot read and write (AOR=42.89, 95% CI 13.23 to 111.28, p<0.001), attend primary school (AOR=22.11, 95% CI 6.98 to 55.99, p<0.001) and secondary school (AOR=4.20, 95% CI 1.42 to 12.51, p<0.001), diagnosed with haemorrhagic stroke (AOR=2.68, 95% CI 1.62 to 4.43, p<0.001) and delayed hospital arrival more than 24 hours (AOR=2.92, 95% CI 1.83 to 4.66, p=0.001) were the independent predictors of poor treatment outcome.ConclusionsApproximately half of the patients who had a stroke had poor treatment outcomes. Ischaemic stroke was the most predominantly diagnosed stroke type. Education status, types of stroke and the median time from onset of symptoms to hospitalisation were the predictors of treatment outcome. Health education should be given to patients regarding clinical symptoms of stroke. In addition, local healthcare providers need to consider the above risk factors while managing stroke.

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