追踪认知加工治疗中的个体化瓶颈:改变的数量很重要。

IF 2.4 3区 医学 Q2 PSYCHIATRY
Philip Held, Daniel R Szoke, Sarah A Pridgen, Dale L Smith
{"title":"追踪认知加工治疗中的个体化瓶颈:改变的数量很重要。","authors":"Philip Held, Daniel R Szoke, Sarah A Pridgen, Dale L Smith","doi":"10.1002/jts.23155","DOIUrl":null,"url":null,"abstract":"<p><p>Cognitive processing therapy (CPT) targets maladaptive beliefs called \"stuck points,\" which are typically assessed using standardized measures (e.g., the Posttraumatic Cognitions Inventory [PTCI]). This study examined whether changes in person-specific individualized stuck points (ISPs) were associated with reductions in self-reported and clinician-rated posttraumatic stress disorder (PTSD) symptoms and whether ISPs predicted PTSD severity beyond general stuck points (GSPs) measured using the PTCI. Adults (N = 57) with PTSD received 1-week massed virtual CPT via one of two randomized controlled trials. ISPs were tracked, and ISP belief strengths were rated after every other session and at 1- and 3-month follow-ups. Linear mixed-effects models examined associations between ISP changes and self-reported (PTSD Checklist for DSM-5 [PCL-5]) and clinician-rated PTSD (Clinician-Administered PTSD Scale for DSM-5 [CAPS-5]) symptom reductions, adjusting for baseline depression, gender, age, and treatment condition. Participants showed large reductions in PTSD symptoms from baseline to 1-month follow-up, M<sub>PCL-5 reduction</sub> = 29.4, d = 2.02; M<sub>CAPS-5 reduction</sub> = 10.49, d = 0.72. Average ISP belief strength decreased by 50.2% during treatment and up to 1-month follow-up, d = 2.75. Higher numbers of ISPs also predicted reduced PCL-5 scores, p = .021, R<sup>2</sup> = .02. However, when controlling for PTCI score, ISPs no longer significantly predicted PTSD symptom change, ps = .352-.534, whereas PTCI scores remained significant predictors, p < .001. ISP reductions were associated with PTSD symptom improvements but did not predict outcomes beyond PTCI-assessed GSPs. Tracking ISPs may still be valuable for tailoring therapy and enhancing patient engagement.</p>","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Tracking individualized stuck points in cognitive processing therapy: The amount of change matters.\",\"authors\":\"Philip Held, Daniel R Szoke, Sarah A Pridgen, Dale L Smith\",\"doi\":\"10.1002/jts.23155\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Cognitive processing therapy (CPT) targets maladaptive beliefs called \\\"stuck points,\\\" which are typically assessed using standardized measures (e.g., the Posttraumatic Cognitions Inventory [PTCI]). This study examined whether changes in person-specific individualized stuck points (ISPs) were associated with reductions in self-reported and clinician-rated posttraumatic stress disorder (PTSD) symptoms and whether ISPs predicted PTSD severity beyond general stuck points (GSPs) measured using the PTCI. Adults (N = 57) with PTSD received 1-week massed virtual CPT via one of two randomized controlled trials. ISPs were tracked, and ISP belief strengths were rated after every other session and at 1- and 3-month follow-ups. Linear mixed-effects models examined associations between ISP changes and self-reported (PTSD Checklist for DSM-5 [PCL-5]) and clinician-rated PTSD (Clinician-Administered PTSD Scale for DSM-5 [CAPS-5]) symptom reductions, adjusting for baseline depression, gender, age, and treatment condition. Participants showed large reductions in PTSD symptoms from baseline to 1-month follow-up, M<sub>PCL-5 reduction</sub> = 29.4, d = 2.02; M<sub>CAPS-5 reduction</sub> = 10.49, d = 0.72. Average ISP belief strength decreased by 50.2% during treatment and up to 1-month follow-up, d = 2.75. Higher numbers of ISPs also predicted reduced PCL-5 scores, p = .021, R<sup>2</sup> = .02. However, when controlling for PTCI score, ISPs no longer significantly predicted PTSD symptom change, ps = .352-.534, whereas PTCI scores remained significant predictors, p < .001. ISP reductions were associated with PTSD symptom improvements but did not predict outcomes beyond PTCI-assessed GSPs. Tracking ISPs may still be valuable for tailoring therapy and enhancing patient engagement.</p>\",\"PeriodicalId\":17519,\"journal\":{\"name\":\"Journal of traumatic stress\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-05-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of traumatic stress\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jts.23155\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of traumatic stress","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jts.23155","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0

摘要

认知加工疗法(CPT)针对的是被称为“卡点”的不适应信念,通常使用标准化的测量方法(例如,创伤后认知量表[PTCI])来评估。本研究考察了个人特异性个性化阻滞点(ISPs)的变化是否与自我报告和临床评定的创伤后应激障碍(PTSD)症状的减少有关,以及ISPs是否预测PTSD严重程度超过使用PTCI测量的一般阻滞点(GSPs)。通过两项随机对照试验中的一项,患有PTSD的成人(N = 57)接受了为期一周的大规模虚拟CPT。对互联网服务提供商进行了跟踪,并在每隔一次会议和1个月和3个月的随访后对互联网服务提供商的信念强度进行了评估。线性混合效应模型检验了ISP变化与自我报告(DSM-5的PTSD检查表[PCL-5])和临床评定的PTSD (DSM-5的临床管理的PTSD量表[CAPS-5])症状减轻之间的关系,调整了基线抑郁、性别、年龄和治疗条件。从基线到随访1个月,受试者PTSD症状显著减轻,MPCL-5减轻= 29.4,d = 2.02;MCAPS-5降低率= 10.49,d = 0.72。在治疗和随访1个月期间,平均ISP信念强度下降50.2%,d = 2.75。isp数量越多,PCL-5评分也会降低,p = 0.021, R2 = 0.02。然而,在控制PTCI评分后,isp不再显著预测PTSD症状变化,ps = .352-。534,而PTCI评分仍然是显著的预测因子,p
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Tracking individualized stuck points in cognitive processing therapy: The amount of change matters.

Cognitive processing therapy (CPT) targets maladaptive beliefs called "stuck points," which are typically assessed using standardized measures (e.g., the Posttraumatic Cognitions Inventory [PTCI]). This study examined whether changes in person-specific individualized stuck points (ISPs) were associated with reductions in self-reported and clinician-rated posttraumatic stress disorder (PTSD) symptoms and whether ISPs predicted PTSD severity beyond general stuck points (GSPs) measured using the PTCI. Adults (N = 57) with PTSD received 1-week massed virtual CPT via one of two randomized controlled trials. ISPs were tracked, and ISP belief strengths were rated after every other session and at 1- and 3-month follow-ups. Linear mixed-effects models examined associations between ISP changes and self-reported (PTSD Checklist for DSM-5 [PCL-5]) and clinician-rated PTSD (Clinician-Administered PTSD Scale for DSM-5 [CAPS-5]) symptom reductions, adjusting for baseline depression, gender, age, and treatment condition. Participants showed large reductions in PTSD symptoms from baseline to 1-month follow-up, MPCL-5 reduction = 29.4, d = 2.02; MCAPS-5 reduction = 10.49, d = 0.72. Average ISP belief strength decreased by 50.2% during treatment and up to 1-month follow-up, d = 2.75. Higher numbers of ISPs also predicted reduced PCL-5 scores, p = .021, R2 = .02. However, when controlling for PTCI score, ISPs no longer significantly predicted PTSD symptom change, ps = .352-.534, whereas PTCI scores remained significant predictors, p < .001. ISP reductions were associated with PTSD symptom improvements but did not predict outcomes beyond PTCI-assessed GSPs. Tracking ISPs may still be valuable for tailoring therapy and enhancing patient engagement.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
5.80
自引率
6.10%
发文量
125
期刊介绍: Journal of Traumatic Stress (JTS) is published for the International Society for Traumatic Stress Studies. Journal of Traumatic Stress , the official publication for the International Society for Traumatic Stress Studies, is an interdisciplinary forum for the publication of peer-reviewed original papers on biopsychosocial aspects of trauma. Papers focus on theoretical formulations, research, treatment, prevention education/training, and legal and policy concerns. Journal of Traumatic Stress serves as a primary reference for professionals who study and treat people exposed to highly stressful and traumatic events (directly or through their occupational roles), such as war, disaster, accident, violence or abuse (criminal or familial), hostage-taking, or life-threatening illness. The journal publishes original articles, brief reports, review papers, commentaries, and, from time to time, special issues devoted to a single topic.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信