Kristen H Walter, Nicholas P Otis, Alexander C Kline, Erin L Miggantz, W Michael Hunt, Lisa H Glassman
{"title":"有帮助吗？创伤后应激障碍和重度抑郁症美国军人的治疗结果、实践任务依从性和帮助性。","authors":"Kristen H Walter, Nicholas P Otis, Alexander C Kline, Erin L Miggantz, W Michael Hunt, Lisa H Glassman","doi":"10.1080/16506073.2025.2482155","DOIUrl":null,"url":null,"abstract":"<p><p>Practice assignments (i.e. homework) are a key component in cognitive behavioral therapies that predict treatment outcomes for posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) separately. However, research has not explored these variables among individuals with comorbid PTSD and MDD. This study evaluated whether practice assignment adherence and helpfulness predicted PTSD (Clinician-Administered PTSD Scale for DSM-5; CAPS-5) and MDD (Montgomery-Åsberg Depression Rating Scale; MADRS) outcomes at posttreatment and 3-month follow-up. Data were derived from a randomized clinical trial comparing cognitive processing therapy (CPT) and behavioral activation-enhanced CPT (BA+CPT) among 83 U.S. active duty service members with comorbid PTSD and MDD. Participants reported greater assignment adherence in BA+CPT than CPT (<i>p</i> = .008), primarily due to higher adherence to BA assignments within BA+CPT. Multilevel models indicated helpfulness ratings were significantly related to decreased CAPS-5 scores (<i>p</i> = .044) but not MADRS scores (<i>p</i> = .074); service members with the highest helpfulness ratings achieved the best outcomes. Adherence was not significantly related to CAPS-5 (<i>p</i> = .494) or MADRS (<i>p</i> = .114) outcomes. Findings provide clinical insights regarding compliance in integrated treatments and highlight the value in assessing helpfulness of practice assignments during treatment.</p>","PeriodicalId":10535,"journal":{"name":"Cognitive Behaviour Therapy","volume":" ","pages":"1-19"},"PeriodicalIF":4.3000,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Was it helpful? Treatment outcomes and practice assignment adherence and helpfulness among U.S. service members with PTSD and MDD.\",\"authors\":\"Kristen H Walter, Nicholas P Otis, Alexander C Kline, Erin L Miggantz, W Michael Hunt, Lisa H Glassman\",\"doi\":\"10.1080/16506073.2025.2482155\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Practice assignments (i.e. homework) are a key component in cognitive behavioral therapies that predict treatment outcomes for posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) separately. However, research has not explored these variables among individuals with comorbid PTSD and MDD. This study evaluated whether practice assignment adherence and helpfulness predicted PTSD (Clinician-Administered PTSD Scale for DSM-5; CAPS-5) and MDD (Montgomery-Åsberg Depression Rating Scale; MADRS) outcomes at posttreatment and 3-month follow-up. Data were derived from a randomized clinical trial comparing cognitive processing therapy (CPT) and behavioral activation-enhanced CPT (BA+CPT) among 83 U.S. active duty service members with comorbid PTSD and MDD. Participants reported greater assignment adherence in BA+CPT than CPT (<i>p</i> = .008), primarily due to higher adherence to BA assignments within BA+CPT. Multilevel models indicated helpfulness ratings were significantly related to decreased CAPS-5 scores (<i>p</i> = .044) but not MADRS scores (<i>p</i> = .074); service members with the highest helpfulness ratings achieved the best outcomes. Adherence was not significantly related to CAPS-5 (<i>p</i> = .494) or MADRS (<i>p</i> = .114) outcomes. Findings provide clinical insights regarding compliance in integrated treatments and highlight the value in assessing helpfulness of practice assignments during treatment.</p>\",\"PeriodicalId\":10535,\"journal\":{\"name\":\"Cognitive Behaviour Therapy\",\"volume\":\" \",\"pages\":\"1-19\"},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2025-03-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cognitive Behaviour Therapy\",\"FirstCategoryId\":\"102\",\"ListUrlMain\":\"https://doi.org/10.1080/16506073.2025.2482155\",\"RegionNum\":2,\"RegionCategory\":\"心理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHOLOGY, CLINICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cognitive Behaviour Therapy","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1080/16506073.2025.2482155","RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}
Was it helpful? Treatment outcomes and practice assignment adherence and helpfulness among U.S. service members with PTSD and MDD.
Practice assignments (i.e. homework) are a key component in cognitive behavioral therapies that predict treatment outcomes for posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) separately. However, research has not explored these variables among individuals with comorbid PTSD and MDD. This study evaluated whether practice assignment adherence and helpfulness predicted PTSD (Clinician-Administered PTSD Scale for DSM-5; CAPS-5) and MDD (Montgomery-Åsberg Depression Rating Scale; MADRS) outcomes at posttreatment and 3-month follow-up. Data were derived from a randomized clinical trial comparing cognitive processing therapy (CPT) and behavioral activation-enhanced CPT (BA+CPT) among 83 U.S. active duty service members with comorbid PTSD and MDD. Participants reported greater assignment adherence in BA+CPT than CPT (p = .008), primarily due to higher adherence to BA assignments within BA+CPT. Multilevel models indicated helpfulness ratings were significantly related to decreased CAPS-5 scores (p = .044) but not MADRS scores (p = .074); service members with the highest helpfulness ratings achieved the best outcomes. Adherence was not significantly related to CAPS-5 (p = .494) or MADRS (p = .114) outcomes. Findings provide clinical insights regarding compliance in integrated treatments and highlight the value in assessing helpfulness of practice assignments during treatment.
期刊介绍：
Cognitive Behaviour Therapy is a peer reviewed, multidisciplinary journal devoted to the application of behavioural and cognitive sciences to clinical psychology and psychotherapy. The journal publishes state-of-the-art scientific articles within: - clinical and health psychology - psychopathology - behavioural medicine - assessment - treatment - theoretical issues pertinent to behavioural, cognitive and combined cognitive behavioural therapies With the number of high quality contributions increasing, the journal has been able to maintain a rapid publication schedule, providing readers with the latest research in the field.
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