在患有PTSD和重度抑郁症的军人中，有或没有行为激活的认知加工治疗的突然收益

IF 4.2 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy Pub Date : 2025-04-22 DOI:10.1016/j.brat.2025.104753

Nicholas P. Otis , Alexander C. Kline , Lisa H. Glassman , W. Michael Hunt , Kristen H. Walter

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引用次数: 0

摘要

在治疗过程中，突然的增加——症状的大幅度、快速和稳定的减轻——与更好的患者预后相关。对于同时发生创伤后应激障碍（PTSD）和重度抑郁症（MDD）的患者的突然获益知之甚少，但更好地了解这一人群的突然获益可能会改善这种合并症的治疗。本研究评估了合并PTSD和MDD的现役军人（N = 94） PTSD和抑郁症状的突然增加及其与治疗结果的关系，这些人被随机分配到行为激活增强认知加工疗法（BA + CPT）或单独CPT。结果是在治疗后和3个月随访时访谈者评定的创伤后应激障碍和抑郁严重程度。PTSD和抑郁症的突然增加分别发生在19%和27%的样本中。多水平模型显示，抑郁症状的突然增加与PTSD的临床和统计学显著改善相关(p <；.001)和抑郁严重程度(p <；措施)的结果。PTSD突然增加与PTSD （p = .137）或抑郁（p = .187）结果无关。突发性抑郁增加后PTSD和抑郁结果的改善可能突出了治疗期间抑郁症状改变作为这一合并症人群预后标志的重要性。临床试验政府鉴定号nct02874131。

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Sudden gains in cognitive processing therapy with and without behavioral activation among service members with comorbid PTSD and MDD

Sudden gains—large, rapid, and stable symptom reductions during treatment—are associated with better patient outcomes. Little is known about sudden gains among patients with co-occurring posttraumatic stress disorder (PTSD) and major depressive disorder (MDD), yet better understanding of sudden gains in this population may improve treatment of this comorbidity. This study evaluated sudden gains in PTSD and depression symptoms and their association with treatment outcomes among active duty service members with comorbid PTSD and MDD (N = 94) who were randomized to behavioral activation-enhanced cognitive processing therapy (BA + CPT) or CPT alone. Outcomes were interviewer-rated PTSD and depression severity at posttreatment and 3-month follow-up. PTSD and depression sudden gains occurred in 19 % and 27 % of the sample, respectively. Multilevel modeling showed sudden gains in depression symptoms were associated with clinically and statistically significant improvements in PTSD (p < .001) and depression severity (p < .001) outcomes. PTSD sudden gains were not associated with PTSD (p = .137) or depression (p = .187) outcomes. Improvements in both PTSD and depression outcomes following sudden depression gains may highlight the importance of depression symptom change during treatment as a prognostic marker of outcomes in this comorbid population.

Clinicaltrials gov identifier

NCT02874131.

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来源期刊

Behaviour Research and Therapy PSYCHOLOGY, CLINICAL-

CiteScore

7.50

自引率

7.30%

发文量

148

期刊介绍： The major focus of Behaviour Research and Therapy is an experimental psychopathology approach to understanding emotional and behavioral disorders and their prevention and treatment, using cognitive, behavioral, and psychophysiological (including neural) methods and models. This includes laboratory-based experimental studies with healthy, at risk and subclinical individuals that inform clinical application as well as studies with clinically severe samples. The following types of submissions are encouraged: theoretical reviews of mechanisms that contribute to psychopathology and that offer new treatment targets; tests of novel, mechanistically focused psychological interventions, especially ones that include theory-driven or experimentally-derived predictors, moderators and mediators; and innovations in dissemination and implementation of evidence-based practices into clinical practice in psychology and associated fields, especially those that target underlying mechanisms or focus on novel approaches to treatment delivery. In addition to traditional psychological disorders, the scope of the journal includes behavioural medicine (e.g., chronic pain). The journal will not consider manuscripts dealing primarily with measurement, psychometric analyses, and personality assessment.