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The Impact of Prolonged Exposure on PTSD Symptoms and Associated Psychopathology in People Living with HIV: A Randomized Test of Concept

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Abstract

People living with HIV (PLWH) report elevated levels of posttraumatic stress disorder symptoms (PTSS) and associated comorbidities. The present study tested the efficacy of prolonged exposure (PE) at reducing PTSS, depression, negative posttraumatic cognitions, and substance use in PLWH. Participants were randomly assigned to receive PE (n = 40) or to a weekly monitoring control group (n = 25). Assessments occurred at baseline, post-intervention and 3-months post-treatment. Following the 3-month assessment, controls were offered the intervention. All PE recipients (whether originally from the PE or control group) completed a 6-month assessment. Intent-to-treat mixed model repeated measures ANOVAs were conducted through 3-months post-treatment; within group analyses were conducted through 6-months. PE recipients reported fewer PTSS and negative posttraumatic cognitions and were more likely to achieve good end-state functioning; gains were maintained at 6-months. No between-group differences emerged for substance use. Overall, results support the efficacy of PE in PLWH.

Resumen

Las personas que viven con VIH (PLWH por sus siglas en inglés) presentan niveles elevados de los síntomas de trastorno de estrés postraumático (TEPT) y las comorbilidades asociadas. En el estudio actual se examinó la eficacia de la exposición prolongada (EP) por la reducción de TEPT, la depresión, las cogniciones postraumáticas negativas, y el uso de sustancias en PLWH. Los participantes fueron asignados de manera aleatoria a recibir la EP (n = 40), o a un grupo control con supervisión semanal (n = 25). Las evaluaciones fueron realizadas a la línea base, después de la intervención, y a los 3 meses después del tratamiento. Terminada esta última evaluación, se les ofreció la intervención a los miembros del grupo de control. Todos los receptores de la EP (sean originalmente miembros del grupo EP o del control) completaron una evaluación a los 6 meses. Se realizaron los ANOVAs de medidas repetidas y modelos mixtos por intención de tratamiento hasta los 3 meses después del tratamiento; los análisis dentro del grupo se llevaron a cabo hasta los 6 meses. Los receptores de la EP mostraron menos síntomas de TEPT y cogniciones postraumáticas negativas, y tuvieron más probabilidad de lograr buen funcionamiento en el estado final; los beneficios se mantenían a los 6 meses. No hubo diferencias entre los grupos en cuanto al uso de sustancias. En general, los resultados apoyan la eficacia de la EP en PLWH.

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Acknowledgments

Funding for this study was provided by the National Institute of Mental Health (R34 MH 71201).

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Pacella, M.L., Armelie, A., Boarts, J. et al. The Impact of Prolonged Exposure on PTSD Symptoms and Associated Psychopathology in People Living with HIV: A Randomized Test of Concept. AIDS Behav 16, 1327–1340 (2012). https://doi.org/10.1007/s10461-011-0076-y

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