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Patient characteristics as a moderator of posttraumatic stress disorder treatment outcome: combining symptom burden and strengths

Published online by Cambridge University Press:  02 January 2018

Marylene Cloitre ,
Eva Petkova ,
Zhe Su  and
Brandon J. Weiss
Marylene Cloitre*
Affiliation:
National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Menlo Park, California, USA NYU Langone Medical Center, New York, USA
Eva Petkova
Affiliation:
Department of Child & Adolescent Psychiatry, NYU Langone Medical Center; Nathan Kline Institute for Psychiatric Research, New York State Office of Mental Health, New York, New York, USA
Zhe Su
Affiliation:
Department of Child & Adolescent Psychiatry, NYU Langone Medical Center, New York, New York, USA
Brandon J. Weiss
Affiliation:
National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Menlo Park, California, USA Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
*
Marylene Cloitre, National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA 94025, USA. Email: marylene.cloitre@va.gov
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Abstract

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Background

Post-traumatic stress disorder (PTSD) psychotherapy research has failed to identify patient characteristics that consistently predict differential outcome.

Aims

To identify patient characteristics associated with differential outcome via a statistically generated composite moderator among women with childhood abuse-related PTSD in a randomised controlled trial comparing exposure therapy, skills training and their combination.

Method

Six baseline patient characteristics were combined in a composite moderator of treatment effects for PTSD symptoms across the three treatment conditions through a 6-month follow-up.

Results

The optimal moderator was the combined burden of all symptoms and emotion regulation strength. Those with high moderator scores, reflecting high symptom load relative to emotion regulation, did least well in exposure, moderately well in skills and best in the combination.

Conclusions

A clinically meaningful moderator, which combines patient symptom burden and strengths, was identified. Assessment at follow-up may provide a more accurate indicator of variability in outcome than that obtained immediately post-treatment.

Type
Research Article
Information
BJPsych Open , Volume 2 , Issue 2 , March 2016 , pp. 101 - 106
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Copyright
Copyright © The Royal College of Psychiatrists 2016

Footnotes

Declaration of interest

None.

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