Rosner, Rita and Rimane, Eline and Frick, Ulrich and Gutermann, Jana and Hagl, Maria and Renneberg, Babette and Schreiber, Franziska and Vogel, Anna and Steil, Regina (2019) Effect of Developmentally Adapted Cognitive Processing Therapy for Youth With Symptoms of Posttraumatic Stress Disorder After Childhood Sexual and Physical Abuse A Randomized Clinical Trial. JAMA PSYCHIATRY, 76 (5). pp. 484-491. ISSN 2168-622X, 2168-6238
Full text not available from this repository. (Request a copy)Abstract
IMPORTANCE Despite the high prevalence, evidence-based treatments for abuse-related posttraumatic stress disorder (PTSD) in adolescents have rarely been studied. OBJECTIVE To examine whether developmentally adapted cognitive processing therapy (D-CPT) is more effective than a wait-list condition with treatment advice (WL/TA) among adolescents with PTSD related to childhood abuse. DESIGN, SETTING; AND PARTICIPANTS This rater-blinded, multicenter, randomized clinical trial (stratified by center) enrolled treatment-seeking adolescents and young adults (aged 14-21 years) with childhood abuse-related PTSD at 3 university outpatient clinics in Germany from July 2013 to June 2015, with the last follow-up interview conducted by May 2016. Of 194 patients, 88 were eligible for randomization. INTERVENTIONS Participants received D-CPT or WL/TA. Cognitive processing therapy was enhanced by a motivational and alliance-building phase, by including emotion regulation and consideration of typical developmental tasks, and by higher session frequency in the trauma-focused core CPT phase. In WL/TA, participants received treatment advice with respective recommendations of clinicians and were offered D-CPT after 7 months. MAIN OUTCOMES AND MEASURES All outcomes were assessed before treatment (baseline), approximately 8 weeks after the start of treatment, after the end of treatment (posttreatment), and at the 3-month follow-up. The primary outcome, PTSD symptom severity, was assessed in clinical interview (Clinician-Administered PTSD Scale for Children and Adolescents for DSM-W [CAPS-CA]). Secondary outcomes were self-reported PTSD severity, depression, borderline symptoms, behavior problems, and dissociation. RESULTS The 88 participants (75 [85%] female) had a mean age of 18.1years (95% Cl, 17.6-18.6 years). In the intention-to-treat analysis, the 44 participants receiving D-CPT (39 [89%] female) demonstrated greater improvement than the 44 WL/TA participants (36 [82%] female) in terms of PTSD severity (mean CAPS-CA scores, 24.7 [95% Cl, 16.6-32.7] vs 47.5 [95% Cl, 37.9-57.1]; Hedges g = 0.90). This difference was maintained through the follow-up (mean CAPS-CA scores, 25.9 [95% Cl, 16.2-35.6] vs 47.3 [95% Cl, 37.8-56.8]; Hedges g = 0.80). Treatment success was greatest during the trauma-focused core phase. The D-CPT participants also showed greater and stable improvement in all secondary outcomes, with between-groups effect sizes ranging from 0.65 to 1.08 at the posttreatment assessment (eg, for borderline symptoms, 14.1 [95% Cl, 8.0-20.2] vs 32.0 [95% Cl, 23.8-40.2]; Hedges g = 0.91). CONCLUSIONS AND RELEVANCE Adolescents and young adults with abuse-related PTSD benefited more from D-CPT than from WL/TA. Treatment success was stable at the follow-up and generalized to borderline symptoms and other comorbidities.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | PTSD; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Psychiatrie und Psychotherapie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 Apr 2020 06:48 |
| Last Modified: | 09 Apr 2020 06:48 |
| URI: | https://pred.uni-regensburg.de/id/eprint/27084 |
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