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

Valentijn V P Alting Van Geusau,Suzy J M A Matthijssen,Jeroen D Mulder

doi:10.3390/jcm10184152

Valentijn V P Alting Van Geusau, Suzy J M A Matthijssen + Show 1 more

Open Access

https://doi.org/10.3390/jcm10184152

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Abstract

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.

Highlights

Post-traumatic Stress Disorder (PTSD) is a stress-related disorder that one can develop after being exposed to one or more traumatic events [1]
This paper studied whether change in PTSD symptomatology during treatment predicts treatment outcome
This was assessed in an outpatient intensive treatment program for PTSD, in which Prolonged Exposure (PE), Eye Movement Desensitization and Reprocessing (EMDR), physical activity and psychoeducation were combined

Summary

Introduction

Post-traumatic Stress Disorder (PTSD) is a stress-related disorder that one can develop after being exposed to one or more traumatic events [1]. There are several evidence-based treatments for PTSD [4,5]. Among these are Eye Movement Desensitization and Reprocessing (EMDR), Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Prolonged Exposure (PE), and Cognitive Processing Therapy (CPT) which all show good effect sizes in reducing PTSD symptoms [6]. EMDR therapy seems to be the most cost-effective treatment [7]. There are effective trauma treatments, drop-out rates are often high. In a meta-analysis by [8], an average drop-out rate of 18% was found among active treatments in clinical trials for PTSD but drop-out rates as high as 54% are reported in some studies [9]

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