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https://www.readbyqxmd.com/read/29344631/a-brief-exposure-based-treatment-vs-cognitive-processing-therapy-for-posttraumatic-stress-disorder-a-randomized-noninferiority-clinical-trial
#1
Denise M Sloan, Brian P Marx, Daniel J Lee, Patricia A Resick
Importance: Written exposure therapy (WET), a 5-session intervention, has been shown to efficaciously treat posttraumatic stress disorder (PTSD). However, this treatment has not yet been directly compared with a first-line PTSD treatment such as cognitive processing therapy (CPT). Objective: To determine if WET is noninferior to CPT in patients with PTSD. Design, Setting, and Participants: In this randomized clinical trial conducted at a Veterans Affairs medical facility between February 28, 2013, and November 6, 2016, 126 veteran and nonveteran adults were randomized to either WET or CPT...
January 17, 2018: JAMA Psychiatry
https://www.readbyqxmd.com/read/29283617/treating-ptsd-in-primary-care-one-small-step-is-one-giant-leap
#2
Andrew S Pomerantz
Comments on an article by J. A. Cigrang et al. (see record 2017-56601-006). At first glance, the article by Cigrang et al. is another in a long line of randomized clinical trials of psychotherapy for a common condition. Under closer scrutiny, however, it is a groundbreaking study that challenges many commonly held beliefs about effective interventions for posttraumatic stress disorder (PTSD). Cigrang et al. have begun to change the status quo with this study within the DoD. The same protocol is now in the early stages of implementation as a pilot in the VA's Patient Aligned Care Team (VA equivalent of the Patient Centered Medical Home)...
December 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/29178377/examination-of-the-world-health-organization-disability-assessment-system-as-a-measure-of-disability-severity-among-veterans-receiving-cognitive-processing-therapy
#3
Jeremiah A Schumm, Whitney L Gore, Kathleen M Chard, Eric C Meyer
Cognitive processing therapy (CPT) is effective for reducing posttraumatic stress disorder (PTSD) and depression among military veterans. However, studies have not examined whether CPT is associated with reductions in disability severity. The current study examines the association between disability severity and PTSD and depression among U.S. veterans who are receiving CPT. Veterans completed measures at pre- and posttreatment and received CPT through a Veterans Affairs PTSD outpatient (n = 155) or residential (n = 177) program...
November 27, 2017: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/29160555/the-effect-of-sleep-disorders-sedating-medications-and-depression-on-cognitive-processing-therapy-outcomes-a-fuzzy-set-qualitative-comparative-analysis
#4
Patricia L Haynes, Sarah E Emert, Dana Epstein, Suzanne Perkins, Sairam Parthasarathy, James Wilcox
Cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) is an effortful process requiring engagement in cognitive restructuring. Sleep disorders may lead to avoidance of effortful tasks and cognitive performance deficits. We explored whether sleep disorders, as assessed by polysomnography, were consistently associated with treatment response in combination with other factors. This study included 32 U.S. veterans who were examined both before and after CPT for combat-related PTSD. We employed a novel, case-comparative technique, fuzzy set qualitative comparative analysis (fsQCA), to identify combinations of fuzzy and crisp factors (recipes) that achieve a clinically significant outcome...
November 21, 2017: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/29145788/quality-of-life-following-treatment-for-ptsd-comparison-of-videoconferencing-and-in-person-modalities
#5
Lisa H Glassman, Margaret-Anne Mackintosh, Alexander Talkovsky, Stephanie Y Wells, Kristen H Walter, Induni Wickramasinghe, Leslie A Morland
Introduction Quality of life (QOL) is significantly impaired among individuals with post-traumatic stress disorder (PTSD); however, few treatment outcome studies examine QOL following treatment. Furthermore, the use of videoconferencing to deliver evidence-based treatments for PTSD is increasing dramatically. Although videoconferencing has demonstrated non-inferiority to in-person treatment modalities for improving PTSD symptom severity, no studies to date have directly compared QOL outcomes of an evidence-based intervention delivered via videoconferencing to one delivered in-person...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/29131398/response-to-cognitive-processing-therapy-in-veterans-with-and-without-obstructive-sleep-apnea
#6
Franklin Mesa, Benjamin D Dickstein, Virgil D Wooten, Kathleen M Chard
Recent studies have called attention to the need for enhancing treatment outcome in trauma-focused psychotherapies, such as cognitive processing therapy (CPT), with veterans. Given the prevalence of posttraumatic-related sleep disturbances, and the role of sleep in emotional learning and processing, sleep quality may be a target for improving CPT outcome. Elevated rates of obstructive sleep apnea (OSA) have been reported in samples of veterans with posttraumatic stress disorder (PTSD); however, the impact of OSA on response to CPT is unclear...
November 13, 2017: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/29107036/evaluation-of-an-integrated-treatment-for-active-duty-service-members-with-comorbid-posttraumatic-stress-disorder-and-major-depressive-disorder-study-protocol-for-a-randomized-controlled-trial
#7
Kristen H Walter, Lisa H Glassman, W Michael Hunt, Nicholas P Otis, Cynthia J Thomsen
Posttraumatic stress disorder (PTSD) commonly co-occurs with major depressive disorder (MDD) in both civilian and military/veteran populations. Existing, evidence-based PTSD treatments, such as cognitive processing therapy (CPT), often reduce symptoms of both PTSD and depression; however, findings related to the influence of comorbid MDD on PTSD treatment outcomes are mixed, and few studies use samples of individuals with both conditions. Behavioral activation (BA), an approach that relies on behavioral principles, is an effective treatment for depression...
October 26, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28878718/errors-in-the-2017-apa-clinical-practice-guideline-for-the-treatment-of-ptsd-what-the-data-actually-says
#8
REVIEW
Sarah K Dominguez, Christopher W Lee
The American Psychological Association (APA) Practice Guidelines for the Treatment of Posttraumatic Stress Disorder (PTSD) concluded that there was strong evidence for cognitive behavioral therapy (CBT), cognitive processing therapy (CPT), cognitive therapy (CT), and exposure therapy yet weak evidence for eye movement desensitization and reprocessing (EMDR). This is despite the findings from an associated systematic review which concluded that EMDR leads to loss of PTSD diagnosis and symptom reduction. Depression symptoms were also found to improve more with EMDR than control conditions...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28793834/a-preliminary-examination-of-the-role-of-psychotherapist-fidelity-on-outcomes-of-cognitive-processing-therapy-during-an-rct-for-military-sexual-trauma-related-ptsd
#9
Nicholas Holder, Ryan Holliday, Rush Williams, Kacy Mullen, Alina Surís
While cognitive processing therapy (CPT) is an effective evidence-based treatment for many veterans with military-related post-traumatic stress disorder (PTSD), not all veterans experience therapeutic benefit. To account for the discrepancy in outcomes, researchers have investigated patient- and research design-related factors; however, therapist factors (e.g. fidelity) have received less attention. The present study is a preliminary examination of the effect of psychotherapists' fidelity during CPT on clinical outcomes during a randomized clinical trial (RCT) for military sexual trauma-related PTSD...
August 10, 2017: Cognitive Behaviour Therapy
https://www.readbyqxmd.com/read/28767012/role-of-borderline-personality-disorder-in-the-treatment-of-military-sexual-trauma-related-posttraumatic-stress-disorder-with-cognitive-processing-therapy
#10
Nicholas Holder, Ryan Holliday, Anushka Pai, Alina Surís
Cognitive Processing Therapy (CPT) is an effective evidence-based treatment for many, but not all, veterans with posttraumatic stress disorder (PTSD). Understanding the factors that contribute to poorer response to CPT is important for providing the best care to veterans diagnosed with PTSD. Researchers investigating the effectiveness of CPT for individuals with comorbid personality symptoms have found that borderline personality disorder (BPD) characteristics do not negatively affect treatment outcome; however, participants in those studies were not diagnosed with BPD...
July 2017: Behavioral Medicine
https://www.readbyqxmd.com/read/28741736/increased-mindfulness-skills-as-predictors-of-reduced-trauma-related-guilt-in-treatment-seeking-veterans
#11
Philip Held, Gina P Owens, J Richard Monroe, Kathleen M Chard
The present study examined the predictive role of increased self-reported mindfulness skills on reduced trauma-related guilt in a sample of veterans over the course of residential treatment for posttraumatic stress disorder (PTSD; N = 128). The residential treatment consisted of seven weeks of intensive cognitive processing therapy (CPT) for PTSD, as well as additional psychoeducational groups, including seven sessions on mindfulness skills. Increased mindfulness skills describing, acting with awareness, and accepting without judgment were significantly associated with reductions in trauma-related guilt over the course of treatment...
August 2017: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/28667201/study-protocol-for-a-randomised-controlled-trial-of-cognitive-processing-therapy-for-post-traumatic-stress-disorder-among-japanese-patients-the-safety-power-intimacy-esteem-trust-spinet-study
#12
Masaya Ito, Masaru Horikoshi, Patricia A Resick, Akiko Katayanagi, Mitsuhiro Miyamae, Yuriko Takagishi, Yoshitake Takebayashi, Ayako Kanie, Naotsugu Hirabayashi, Toshiaki A Furukawa
INTRODUCTION: Cognitive processing therapy (CPT) is widely regarded as a safe and effective first-line treatment for individuals with post-traumatic stress disorder (PTSD); however, no comparative studies have been conducted to examine the treatment outcomes in an Asian population. The aim of the present trial is to investigate the efficacy of CPT (individual format) as a treatment for PTSD in a population of Japanese patients. METHODS AND ANALYSIS: A 16-week, single-centre, assessor-masked, randomised, parallel-group superiority trial has been designed to compare the efficacy of CPT in conjunction with treatment as usual (mostly pharmacotherapy and clinical monitoring) versus treatment as usual alone...
June 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28503726/baroreflex-dysfunction-and-augmented-sympathetic-nerve-responses-during-mental-stress-in-veterans-with-post-traumatic-stress-disorder
#13
Jeanie Park, Paul J Marvar, Peizhou Liao, Melanie L Kankam, Seth D Norrholm, Ryan M Downey, S Ashley McCullough, Ngoc-Anh Le, Barbara O Rothbaum
KEY POINTS: Patients with post-traumatic stress disorder (PTSD) are at a significantly higher risk of developing hypertension and cardiovascular disease. The mechanisms underlying this increased risk are not known. Studies have suggested that PTSD patients have an overactive sympathetic nervous system (SNS) that could contribute to cardiovascular risk; however, sympathetic function has not previously been rigorously evaluated in PTSD patients. Using direct measurements of sympathetic nerve activity and pharmacological manipulation of blood pressure, we show that veterans with PTSD have augmented SNS and haemodynamic reactivity during both combat-related and non-combat related mental stress, impaired sympathetic and cardiovagal baroreflex sensitivity, and increased inflammation...
July 15, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28485687/therapeutic-response-to-cognitive-processing-therapy-in-white-and-black-female-veterans-with-military-sexual-trauma-related-ptsd
#14
Ryan P Holliday, Nicholas D Holder, Meredith L C Williamson, Alina Surís
Cognitive Processing Therapy (CPT) is an evidence-based treatment (EBT) for posttraumatic stress disorder (PTSD) which has been validated for female veterans with military-related PTSD. Existing trials have enrolled predominantly White veterans with some studies documenting higher rates of early termination from EBTs among Black females when compared to White females. Data from a previously published randomized clinical trial were used to evaluate the effectiveness of CPT for Black female veterans with military sexual trauma (MST)-related PTSD...
May 9, 2017: Cognitive Behaviour Therapy
https://www.readbyqxmd.com/read/28414493/predictors-of-differential-ptsd-treatment-outcomes-between-veteran-and-civilian-women-after-cognitive-processing-therapy
#15
Robyn L Gobin, Margaret-Anne Mackintosh, Emy Willis, Carolyn B Allard, Karen Kloezeman, Leslie A Morland
OBJECTIVE: This study used data from a recent randomized clinical trial (RCT) that found differences between women veterans and civilians in posttraumatic stress disorder (PTSD) treatment response, with civilians demonstrating greater improvement than did veterans. Despite having similar PTSD severity scores at baseline, veterans scored roughly 18 points higher than civilians did on the Clinician-Administered PTSD Scale (CAPS) at posttreatment (p < .01). This study sought to identify the clinical and treatment variables that were associated with the differential response to treatment demonstrated by the women in the RCT...
April 17, 2017: Psychological Trauma: Theory, Research, Practice and Policy
https://www.readbyqxmd.com/read/28287769/increased-utilization-of-prolonged-exposure-and-cognitive-processing-therapy-over-time-a-case-example-from-a-large-veterans-affairs-posttraumatic-stress-disorder-clinic
#16
Natalie E Hundt, Juliette M Harik, Karin E Thompson, Terri L Barrera, Shannon Reynolds Miles
Prior single-site and regional studies have documented difficulties in implementing prolonged exposure (PE) and cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) into practice in Veterans Affairs (VA) Medical Centers, estimating that between 6% and 13% of VA patients with PTSD receive PE or CPT (Lu, Plagge, Marsiglio, & Dobscha, 2016; Mott et al., 2014; Shiner et al., 2013). However, these studies examined data from fiscal years 2008-2012, and therefore may not reflect more recent utilization patterns...
March 13, 2017: Psychological Services
https://www.readbyqxmd.com/read/28270330/fidelity-to-the-cognitive-processing-therapy-protocol-evaluation-of-critical-elements
#17
Courtney C Farmer, Karen S Mitchell, Kelly Parker-Guilbert, Tara E Galovski
The contributions of individual therapy elements to the overall efficacy of evidence-based practices for the treatment of posttraumatic stress disorder (PTSD) are not well-understood. This study first examined the extent to which theoretically important treatment components of Cognitive Processing Therapy (CPT; i.e., skill in Socratic questioning; prioritizing assimilation; attention to practice assignments; emphasis on expression of natural affect) were successfully administered across the course of therapy for 68 PTSD-positive survivors of interpersonal trauma...
March 2017: Behavior Therapy
https://www.readbyqxmd.com/read/28264720/improving-and-sustaining-delivery-of-cpt-for-ptsd-in-mental-health-systems-a-cluster-randomized-trial
#18
Shannon Wiltsey Stirman, Erin P Finley, Norman Shields, Joan Cook, Rachel Haine-Schlagel, James F Burgess, Linda Dimeff, Kelly Koerner, Michael Suvak, Cassidy A Gutner, David Gagnon, Tasoula Masina, Matthew Beristianos, Kera Mallard, Vanessa Ramirez, Candice Monson
BACKGROUND: Large-scale implementation of evidence-based psychotherapies (EBPs) such as cognitive processing therapy (CPT) for posttraumatic stress disorder can have a tremendous impact on mental and physical health, healthcare utilization, and quality of life. While many mental health systems (MHS) have invested heavily in programs to implement EBPs, few eligible patients receive EBPs in routine care settings, and clinicians do not appear to deliver the full treatment protocol to many of their patients...
March 6, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/27893265/va-residential-treatment-providers-use-of-two-evidence-based-psychotherapies-for-ptsd-global-endorsement-versus-specific-components
#19
Richard Thompson, Vanessa Simiola, Paula P Schnurr, Shannon Wiltsey Stirman, Joan M Cook
Objective: Despite a growing body of knowledge about the dissemination of evidence-based psychotherapies (EBPs), their actual use in clinical settings is not well understood. The purpose of the current study was to compare self-reported component use with global use for 2 EBPs for posttraumatic stress disorder (PTSD), prolonged exposure (PE), and cognitive processing therapy (CPT). Method: Around 174 providers from 38 VA PTSD residential treatment programs were asked about both global use and component use of PE and CPT...
November 28, 2016: Psychological Trauma: Theory, Research, Practice and Policy
https://www.readbyqxmd.com/read/27893032/effect-of-group-vs-individual-cognitive-processing-therapy-in-active-duty-military-seeking-treatment-for-posttraumatic-stress-disorder-a-randomized-clinical-trial
#20
RANDOMIZED CONTROLLED TRIAL
Patricia A Resick, Jennifer Schuster Wachen, Katherine A Dondanville, Kristi E Pruiksma, Jeffrey S Yarvis, Alan L Peterson, Jim Mintz, Elisa V Borah, Antoinette Brundige, Elizabeth A Hembree, Brett T Litz, John D Roache, Stacey Young-McCaughan
Importance: Cognitive processing therapy (CPT), an evidence-based treatment for posttraumatic stress disorder (PTSD), has not been tested as an individual treatment among active-duty military. Group CPT may be an efficient way to deliver treatment. Objective: To determine the effects of CPT on PTSD and co-occurring symptoms and whether they differ when administered in an individual or a group format. Design, Setting, and Participants: In this randomized clinical trial, 268 active-duty servicemembers consented to assessment at an army medical center from March 8, 2012, to September 23, 2014, and were randomized to group or individual CPT...
January 1, 2017: JAMA Psychiatry
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