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Predictors and moderators of treatment outcomes in phase-based treatment and trauma-focused treatments in patients with childhood abuse-related post-traumatic stress disorder
van Vliet,N.I. Huntjens,R.J.C. van Dijk,M.K. Huisman,M. Bachrach,N. Meewisse,M. van Haren,S. de Jongh,A.
van Vliet,N.I.
Huntjens,R.J.C.
van Dijk,M.K.
Huisman,M.
Bachrach,N.
Meewisse,M.
van Haren,S.
de Jongh,A.
Abstract
Background: Knowledge of treatment predictors and moderators is important for improving the effectiveness of treatment for PTSD due to childhood abuse.Objective: The first aim of this study was to test the potential predictive value of variables commonly associated with PTSD resulting from a history of repeated childhood abuse, in relation to treatment outcomes. The second aim was to examine if complex PTSD symptoms act as potential moderators between treatment conditions and outcomes. Method: Data were obtained from a randomized controlled trial comparing a phase-based treatment (Skills Training in Affect and Interpersonal Regulation [STAIR] followed by Eye Movement Desensitization and Reprocessing [EMDR] therapy; n = 57) with a direct trauma-focused treatment (EMDR therapy only; n = 64) in people with PTSD due to childhood abuse. The possible predictive effects of the presence of borderline personality disorder, dissociative symptoms, and suicidal and self-injurious behaviours were examined. In addition, it was determined whether symptoms of emotion regulation difficulties, self-esteem, and interpersonal problems moderated the relation between the treatment condition and PTSD post-treatment, corrected for pre-treatment PTSD severity.Results: Pre-treatment PTSD severity proved to be a significant predictor of less profitable PTSD treatment outcomes. The same was true for the severity of dissociative symptoms, but only post-treatment, and not when corrected for false positives. Complex PTSD symptoms did not moderate the relationship between the treatment conditions and PTSD treatment outcomes. Conclusions: The current findings suggest that regardless of the common comorbid symptoms studied, immediate trauma-focused treatment is a safe and effective option for individuals with childhood-related PTSD. However, individuals experiencing severe symptoms of PTSD may benefit from additional treatment sessions or the addition of other evidence-based PTSD treatment approaches. The predictive influence of dissociative sequelae needs further research.The study design was registered in The Dutch trial register (https://www.trialregister.nl/trialreg/admin/rctview.asp?TC = 5991) NTR5991 and was approved by the medical ethics committee of Twente NL 56641.044.16 CCMO.
Description
Date
2024
Journal Title
Journal ISSN
Volume Title
Publisher
Research Projects
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Journal Issue
Keywords
Humans, Child, Stress Disorders, Post-Traumatic/diagnosis, Treatment Outcome, Child Abuse/therapy, Eye Movement Desensitization Reprocessing/methods, Comorbidity, SDG 16 - Peace, Justice and Strong Institutions
Citation
van Vliet, N I, Huntjens, R J C, van Dijk, M K, Huisman, M, Bachrach, N, Meewisse, M, van Haren, S & de Jongh, A 2024, 'Predictors and moderators of treatment outcomes in phase-based treatment and trauma-focused treatments in patients with childhood abuse-related post-traumatic stress disorder', European Journal of Psychotraumatology, vol. 15, no. 1, 2300589. https://doi.org/10.1080/20008066.2023.2300589
License
info:eu-repo/semantics/openAccess