Abstract
The aim of the present study was to investigate predictors of treatment outcome for Post-traumatic Stress Disorder (PTSD) after treatment completion and at 15-months follow-up (n = 48), in a trial of Eye Movement Desensitisation and Reprocessing (EMDR) versus Imaginal Exposure and Cognitive Restructuring (E+CR). Factors associated with treatment outcome were investigated using regression analyses with the mean change scores in three assessor and self-rated PTSD symptomatology measures, including the Clinician-Administered PTSD Scale (CAPS), the Impact of Events Scale (IES) and the PTSD Symptom Checklist (PCL) from pre- to post-treatment and pre-treatment to follow-up as the dependent variables and demographics, trauma, clinical and personality measures as independent variables. Irrespective to outcome measures and assessment points it was found that four variables were able to predict significantly treatment outcome. These included baseline PTSD symptomatology, number of sessions, gender and therapy type. Overall, our results showed that it is difficult to use pre-treatment variables as a powerful and reliable tool for predicting treatment outcome, as significant predictors were found to be sample-specific and outcome measure-specific. Clinical relevance of the present results and directions for future research are discussed.
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References
Blake D, Weathers F, Nagy L, Kaloupek D, Klauminzer G, Charney D, Keane T (1990) Clinician Administered PTSD Scale (CAPS). National Center for Post-traumatic Stress Disorder, Boston
Bradley R, Greene J, Russ E, Dutra L, Westen D (2005) A multidimensional meta-analysis of psychotherapy for PTSD. Am J Psychiatry 162:214–227
Davidson J, Smith R, Kudler H (1989) Validity and reliability of the DSM-III criteria for post-traumatic stress disorder: experience with a structured interview. J Nerv Ment Dis 177:336–341
Ehlers A, Clark DM, Dunmore E, Jaycox L, Meadows E, Foa EB (1998) Predicting response to exposure treatment in PTSD: the role of mental defeat and alienation. J Trauma Stress 11:457–471
Ehlers A, Clark DM, Hackmann A, McManus F, Fennell M (2005) Cognitive therapy for post-traumatic stress disorder: development and evaluation. Behav Res Therapy 43:413–431
Foa EB (2000) Psychosocial treatment of Posttraumatic Stress Disorder. J Clin Psychiatry 61(suppl. 5):43–48
Foa EB, Riggs DS, Dancu CV, Rothbaum BO (1993) Reliability and validity of a brief instrument for assessing Post-traumatic Stress Disorder. J Trauma Stress 6:459–473
Foa EB, Cashman L, Jaycox L, Perry K (1997) The validation of a self-report measure of posttraumatic stress disorder The Posttraumatic Diagnostic Scale. Psychol Assessment 9:445–451
Forbes D, Creamer M, Hawthorne G, Allen N, McHugh T (2003) Comorbidity as a predictor of symptom change after treatment in combat-related Posttraumatic Stress Disorder. J Nerv Ment Dis 191:93–99
Ford JD, Kidd P (1998) Early childhood trauma and disorders of extreme stress as predictors of treatment outcome with chronic posttraumatic stress disorder. J Trauma Stress 11:743–761
Horowitz M, Wilner N, Alvarez W (1979) Impact of event scale: a measure of subjective stress. Psychosom Med 41:209–218
Joseph P (2000) Psychometric evaluation of Horowitz’s Impact of Event Scale: a review. J Trauma Stress 13:101–113
Marks I, Lovell K, Noshirvani H, Livanou M, Thrasher S (1998). Treatment of post-traumatic stress disorder by exposure and/or cognitive restructuring. Arch Gen Psychiatry 55:317–325
NICE (2005) CG26 Post-traumatic stress disorder (PTSD)—Full guideline
Power K, McGoldrick T, Brown K Buchanan R, Sharp D, Swanson V, Karatzias A (2002) A controlled comparison of Eye Movement Desensitization and Reprocessing versus Exposure plus Cognitive Restructuring Versus Waiting List in the treatment of Post-traumatic Stress Disorder. Clin Psychol Psychot 9:299–318
Shapiro F (1991) EMDR procedure: from EMD and EMD-R—a new treatment model for anxiety and related traumata. Behav Therapist 14:133–135
Shapiro F (1995) Eye movement desensitization and reprocessing: basic principles, protocols and procedures. Guilford, New York
Sharp DM, Power KG (1999) Predicting treatment outcome for Panic Disorder and Agoraphobia in primary care. Clin Psychol Psychot 6:336–348
Tarrier N, Sommerfield C, Pilgrim H, Faragher B (2000) Factors associated with outcome of cognitive-behavioural treatment of post-traumatic stress disorder. Behav Res Therapy 38:191–202
Taylor S (2003) Outcome predictors for three PTSD treatments: exposure therapy, EMDR, and relaxation therapy. J Cogn Psychot: An Int Quart 17:149–162
Van Etten ML, Taylor S (1998) Comparative efficacy of treatments for Posttraumatic Stress Disorder: a meta-analysis. Clin Psychol Psychot 5:125–144
Van Minnen A, Arntz A, Keijsers GPJ (2002) Prolonged exposure in patients with chronic PTSD: predictors of treatment outcome and dropout. Behav Res Therapy 40:439–457
Watson D, Clark LA, Tellegen A (1988) Development and validation of brief measures of Positive and Negative Affect: the PANAS Scales. J Pers Soc Psychol 54:1063–1070
Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiat Scand 67:361–370
Acknowledgements
The research was supported by a grant (K/RED/4/332) to Kevin Power, Theresa McGoldrick and Keith Brown from the Chief Scientist Office (CSO), Scottish Executive. The views expressed in this paper are not necessarily those of the Scottish Executive.
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Karatzias, A., Power, K., McGoldrick, T. et al. Predicting treatment outcome on three measures for post-traumatic stress disorder. Eur Arch Psychiatry Clin Neurosci 257, 40–46 (2007). https://doi.org/10.1007/s00406-006-0682-2
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DOI: https://doi.org/10.1007/s00406-006-0682-2