Long-term effects of dialectical behaviour therapy for posttraumatic stress disorder and cognitive processing therapy 9 months after treatment termination.

IF 4.2 2区 医学 Q1 PSYCHIATRY
Ruben Vonderlin, Kathlen Priebe, Meike Müller-Engelmann, Thomas Fydrich, Regina Steil, Patricia A Resick, Christian Schmahl, Petra Lindauer, Nikolaus Kleindienst, Martin Bohus
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引用次数: 0

Abstract

Background: The complexity of posttraumatic stress disorder (PTSD) symptoms related to childhood abuse (CA) present challenges for effective psychotherapeutic treatment. Consequently, there is great interest in the long-term effectiveness of psychological treatments for this population.Objective: This study aims to investigate the long-term outcomes of Dialectical Behaviour Therapy for PTSD (DBT-PTSD) and Cognitive Processing Therapy (CPT) 9 months after treatment termination.Method: This is a long-term analysis from a randomised-controlled trial of DBT-PTSD versus CPT (registration number DRKS00005578). Initially, 193 individuals with CA-related PTSD were randomly allocated to receive either DBT-PTSD (n = 98) or CPT (n = 95). The primary outcome the Clinician-administered PTSD-Scale for DSM-5 (CAPS-5) was administred at baseline, treatment completion (15 months post-randomization) and at the 9-month follow-up. Secondary outcomes included self-reported PTSD severity (PCL-5), dissociation (DSS), severity of borderline symptoms (BSL-23), and psychosocial functioning (GAF).Results: No significant changes were observed in the primary (CAPS) and all other outcomes from post-intervention to 9-months follow-up in both the DBT-PTSD (CAPS: Mpost  = 15.60, Mfollow-up  = 14.93) and CPT group (CAPS: Mpost = 18.80, Mfollow-up = 17.41). Between-group analyses at 9-months follow-up were significantly in favour of DBT-PTSD compared to CPT with small to medium effect sizes on all outcomes ranging from d = 0.35 on the CAPS to d = 0.57 on the BSL-23 and GAF.Conclusions: Our results indicate that treatment effects of psychotherapy addressing complex presentations of PTSD persist 9 months after treatment termination. In addition, the superiority of DBT-PTSD as compared to CPT found at treatment termination, was confirmed at 9-months follow-up.Trial registration: German Clinical Trials Register identifier: DRKS00005578..

针对创伤后应激障碍的辩证行为疗法和认知处理疗法在治疗终止 9 个月后的长期效果。
背景:与童年虐待(CA)相关的创伤后应激障碍(PTSD)症状十分复杂,给有效的心理治疗带来了挑战。因此,人们非常关注心理治疗对这一人群的长期疗效:本研究旨在调查创伤后应激障碍的辩证行为疗法(DBT-PTSD)和认知加工疗法(CPT)在治疗终止 9 个月后的长期疗效:这是一项DBT-PTSD与CPT随机对照试验(注册号为DRKS00005578)的长期分析。最初,193 名与 CA 相关的创伤后应激障碍患者被随机分配接受 DBT-PTSD (98 人)或 CPT(95 人)治疗。主要结果是在基线、治疗结束(随机分配后 15 个月)和 9 个月随访时使用 DSM-5 临床医师管理创伤后应激障碍量表(CAPS-5)。次要结果包括自我报告的创伤后应激障碍严重程度(PCL-5)、解离(DSS)、边缘症状严重程度(BSL-23)和心理社会功能(GAF):DBT-PTSD组(CAPS:Mpost = 15.60,Mfollow-up = 14.93)和CPT组(CAPS:Mpost = 18.80,Mfollow-up = 17.41)的主要结果(CAPS)和所有其他结果从干预后到9个月随访期间均未观察到明显变化。9个月随访的组间分析结果显示,DBT-PTSD组明显优于CPT组,在所有结果上都有小到中等的效应大小,从CAPS的d = 0.35到BSL-23和GAF的d = 0.57:我们的研究结果表明,针对创伤后应激障碍复杂表现的心理疗法的治疗效果在治疗终止 9 个月后仍然存在。此外,与CPT相比,DBT-PTSD在治疗终止时的优越性在9个月的随访中得到了证实:试验注册:德国临床试验注册标识符:DRKS00005578.
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来源期刊
CiteScore
7.60
自引率
12.00%
发文量
153
审稿时长
18 weeks
期刊介绍: The European Journal of Psychotraumatology (EJPT) is a peer-reviewed open access interdisciplinary journal owned by the European Society of Traumatic Stress Studies (ESTSS). The European Journal of Psychotraumatology (EJPT) aims to engage scholars, clinicians and researchers in the vital issues of how to understand, prevent and treat the consequences of stress and trauma, including but not limited to, posttraumatic stress disorder (PTSD), depressive disorders, substance abuse, burnout, and neurobiological or physical consequences, using the latest research or clinical experience in these areas. The journal shares ESTSS’ mission to advance and disseminate scientific knowledge about traumatic stress. Papers may address individual events, repeated or chronic (complex) trauma, large scale disasters, or violence. Being open access, the European Journal of Psychotraumatology is also evidence of ESTSS’ stand on free accessibility of research publications to a wider community via the web. The European Journal of Psychotraumatology seeks to attract contributions from academics and practitioners from diverse professional backgrounds, including, but not restricted to, those in mental health, social sciences, and health and welfare services. Contributions from outside Europe are welcome. The journal welcomes original basic and clinical research articles that consolidate and expand the theoretical and professional basis of the field of traumatic stress; Review articles including meta-analyses; short communications presenting new ideas or early-stage promising research; study protocols that describe proposed or ongoing research; case reports examining a single individual or event in a real‑life context; clinical practice papers sharing experience from the clinic; letters to the Editor debating articles already published in the Journal; inaugural Lectures; conference abstracts and book reviews. Both quantitative and qualitative research is welcome.
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