Resick Patricia A, LoSavio Stefanie T, Wachen Jennifer Schuster, Dillon Kirsten H, Nason Erica E, Dondanville Katherine A, Young-McCaughan Stacey, Peterson Alan L, Yarvis Jeffrey S, Mintz Jim
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 1121 West Chapel Hill Street, Durham, NC 27707, USA.
Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.
Cognit Ther Res. 2020 Feb 27;44(3):611-620. doi: 10.1007/s10608-020-10085-5.
The purpose of this study was to examine demographic, psychological, military, and deployment variables that might predict posttraumatic stress disorder (PTSD) symptom improvement in a sample of active duty service members who received either group or individual cognitive processing therapy (CPT).
Data were analyzed from 165 active duty service members with pre- and posttreatment data participating in a randomized controlled trial comparing group with individual CPT. Pretreatment variables were examined as predictors of change in PTSD severity from baseline to posttreatment, assessed using the PTSD Symptom Scale-Interview Version (PSS-I). Predictors of PSS-I change were first evaluated using Pearson correlations, followed by partial and multiple correlations to clarify which associations remained when effects of other predictors were controlled. Multiple regression analyses were used to test for interactions between pretreatment variables and treatment format.
Only age was a significant predictor of PTSD symptom change after controlling for other variables and statisitically correcting for testing multiple variables. There was also an interaction between age and treatment format.
Younger participants had greater symptom improvement, particularly if they received individual treatment. Other pretreatment variables did not predict outcome. CPT appears to be robust across most pretreatment variables, such that comorbid disorders, baseline symptom severity, and suicidal ideation do not interfere with application of CPT. However, individual CPT may be a better option particularly for younger service members.
本研究旨在探讨人口统计学、心理学、军事及部署相关变量，这些变量可能预测接受团体或个体认知加工疗法（CPT）的现役军人样本中创伤后应激障碍（PTSD）症状的改善情况。
对165名有治疗前和治疗后数据的现役军人的数据进行分析，这些军人参与了一项将团体CPT与个体CPT进行比较的随机对照试验。将治疗前变量作为从基线到治疗后PTSD严重程度变化的预测因素进行检验，使用创伤后应激障碍症状量表访谈版（PSS-I）进行评估。首先使用Pearson相关性评估PSS-I变化的预测因素，随后进行偏相关和多重相关分析，以明确在控制其他预测因素的影响后哪些关联仍然存在。使用多元回归分析来检验治疗前变量与治疗形式之间的相互作用。
在控制其他变量并对多个变量进行统计校正后，只有年龄是PTSD症状变化的显著预测因素。年龄与治疗形式之间也存在相互作用。
较年轻的参与者症状改善更大，尤其是如果他们接受个体治疗。其他治疗前变量不能预测结果。CPT在大多数治疗前变量中似乎都很有效，以至于共病障碍、基线症状严重程度和自杀意念都不会干扰CPT的应用。然而，个体CPT可能是更好的选择，特别是对于较年轻的军人。
