Duke University Medical Center, Durham, North Carolina, USA.
Center for Child and Family Health, Durham, North Carolina, USA.
J Trauma Stress. 2021 Aug;34(4):757-763. doi: 10.1002/jts.22668. Epub 2021 Mar 14.
Cognitive processing therapy (CPT) is a gold-standard treatment for adults with posttraumatic stress disorder (PTSD). However, adolescents may also benefit from CPT, particularly when existing evidence-based treatments for adolescents are unavailable or not a good fit. In this program evaluation study, community-based therapists participating in training delivered a modular version of CPT to 32 adolescents (age range: 14-17 years) and 174 adults recruited at their sites (overall sample: 81.1% female, 59.7% White, 31.6% Black, 21.6% Hispanic, 2.9% American Indian/Alaskan Native, 1.9% Asian, and 9.7% other race). The same protocol was used for adolescents as adults. Treatment outcomes, including treatment completion status, number of sessions needed, and PTSD and depression symptom change, were compared between groups. In total, 47.1% of adults versus 71.9% of adolescents completed treatment. Among completers, there was no between-group difference in the number of attended sessions, RR = 1.04, 95% CI [0.88, 1.23], p = .576. Overall, in the full intent-to-treat sample (i.e., completers and noncompleters), large symptom reductions were observed for PTSD, b = -3.27, SE = 0.17, p < .001, d = 1.22; and depression, b = -0.82, SE = 0.07, p < .001, d = 0.84. There were no differences in the rate of change for adolescents versus adults regarding PTSD, b = -0.15, SE = 0.48, p = .759; or depression, b = -0.20, SE = 0.14, p = .181. These findings suggest that CPT is a viable treatment option for adolescents, who benefited from treatment and completed treatment at a high rate.
认知加工疗法(CPT)是成人创伤后应激障碍(PTSD)的标准治疗方法。然而,青少年也可能从 CPT 中受益,特别是当现有的针对青少年的循证治疗方法不可用或不适合时。在这项基于社区的治疗师参与培训的方案评估研究中,他们向 32 名青少年(年龄范围:14-17 岁)和在其所在地点招募的 174 名成年人(总体样本:女性占 81.1%,白人占 59.7%,黑人占 31.6%,西班牙裔占 21.6%,美洲印第安人/阿拉斯加原住民占 2.9%,亚裔占 1.9%,其他种族占 9.7%)提供了 CPT 的模块化版本。青少年和成年人使用的方案相同。比较了两组之间的治疗结果,包括治疗完成情况、所需治疗次数以及 PTSD 和抑郁症状的变化。总的来说,47.1%的成年人和 71.9%的青少年完成了治疗。在完成治疗的人群中,参加治疗的次数没有组间差异,RR=1.04,95%CI[0.88,1.23],p=0.576。总体而言,在全意向治疗样本(即完成治疗和未完成治疗者)中,PTSD 的症状大幅减轻,b=-3.27,SE=0.17,p<0.001,d=1.22;抑郁症状也显著减轻,b=-0.82,SE=0.07,p<0.001,d=0.84。青少年和成年人在 PTSD 的变化率方面没有差异,b=-0.15,SE=0.48,p=0.759;或抑郁,b=-0.20,SE=0.14,p=0.181。这些发现表明,CPT 是青少年的一种可行治疗选择,他们从治疗中受益并以高比例完成治疗。