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https://www.readbyqxmd.com/read/29756791/individual-and-group-cognitive-processing-therapy-effectiveness-across-two-veterans-affairs-posttraumatic-stress-disorder-treatment-clinics
#1
Kristen E Lamp, Kimberly M Avallone, Kelly P Maieritsch, Katherine R Buchholz, Sheila A M Rauch
OBJECTIVE: In accordance with Veterans Affairs (VA) policy, VA posttraumatic stress disorder (PTSD) clinics offer evidence-based treatments including cognitive processing therapy (CPT). To facilitate access to care, CPT is offered in both group and individual formats in many VA PTSD clinics. Group and individual delivery of CPT have been directly compared in active duty samples, but these findings have not been extended to VA populations. The present article directly compares the effectiveness of group and individual CPT with a written trauma account (CPT+A) across two VA PTSD clinics...
May 14, 2018: Psychological Trauma: Theory, Research, Practice and Policy
https://www.readbyqxmd.com/read/29573657/reductions-in-self-blame-cognitions-predict-ptsd-improvements-with-cognitive-processing-therapy-for-military-sexual-trauma-related-ptsd
#2
Ryan Holliday, Nicholas Holder, Alina Surís
Reductions in trauma-related negative cognitions during Cognitive Processing Therapy (CPT) are theorized to precede posttraumatic stress disorder (PTSD) symptom reduction. This mechanism of change has not been validated for veterans with military sexual trauma-related PTSD. Using data from a previously published randomized clinical trial (n = 32), changes in trauma-related negative cognitions about self, self-blame, and the world were entered as predictors of change in PTSD symptoms for cross-lagged panel analyses...
March 14, 2018: Psychiatry Research
https://www.readbyqxmd.com/read/29547909/measuring-use-of-evidence-based-psychotherapy-for-ptsd-in-va-residential-treatment-settings-with-clinician-survey-and-electronic-medical-record-templates
#3
Brian Shiner, Christine Leonard Westgate, Vanessa Simiola, Richard Thompson, Paula P Schnurr, Joan M Cook
Objective: Available studies on implementation of evidence-based psychotherapy (EBP) for patients attending Department of Veterans Affairs (VA) residential post-traumatic stress disorder (PTSD) programs rely on therapist self-report of EBP delivery. Patient-level data on receipt of EBP are needed both to corroborate therapist self-report and to understand patient factors that predict receipt of EBPs for PTSD. Materials and Methods: We identified 159 therapists from 38 VA residential PTSD programs who responded to a survey about EBP implementation during the 2015 fiscal year (FY15)...
March 14, 2018: Military Medicine
https://www.readbyqxmd.com/read/29497585/spiritually-integrated-cognitive-processing-therapy-a-new-treatment-for-post-traumatic-stress-disorder-that-targets-moral-injury
#4
Michelle Pearce, Kerry Haynes, Natalia R Rivera, Harold G Koenig
Background: Post-traumatic stress disorder (PTSD) is a debilitating disorder, and current treatments leave the majority of patients with unresolved symptoms. Moral injury (MI) may be one of the barriers that interfere with recovery from PTSD, particularly among current or former military service members. Objective: Given the psychological and spiritual aspects of MI, an intervention that addresses MI using spiritual resources in addition to psychological resources may be particularly effective in treating PTSD...
2018: Global Advances in Health and Medicine: Improving Healthcare Outcomes Worldwide
https://www.readbyqxmd.com/read/29489037/in-rape-trauma-ptsd-patient-characteristics-indicate-which-trauma-focused-treatment-they-are-most-likely-to-complete
#5
John R Keefe, Shannon Wiltsey Stirman, Zachary D Cohen, Robert J DeRubeis, Brian N Smith, Patricia A Resick
BACKGROUND: Dropout rates for effective therapies for posttraumatic stress disorder (PTSD) can be high, especially in practice settings. Although clinicians have intuitions regarding what treatment patients may complete, there are few systematic data to drive those judgments. METHODS: A multivariable model of dropout risk was constructed with randomized clinical trial data (n = 160) comparing prolonged exposure (PE) and cognitive processing therapy (CPT) for rape-induced PTSD...
April 2018: Depression and Anxiety
https://www.readbyqxmd.com/read/29351885/repetitive-tms-to-augment-cognitive-processing-therapy-in-combat-veterans-of-recent-conflicts-with-ptsd-a-randomized-clinical-trial
#6
F Andrew Kozel, Michael A Motes, Nyaz Didehbani, Bambi DeLaRosa, Christina Bass, Caitlin D Schraufnagel, Penelope Jones, Cassie Rae Morgan, Jeffrey S Spence, Michael A Kraut, John Hart
BACKGROUND: The objective was to test whether repetitive Transcranial Magnetic Stimulation (rTMS) just prior to Cognitive Processing Therapy (CPT) would significantly improve the clinical outcome compared to sham rTMS prior to CPT in veterans with PTSD. METHODS: Veterans 18-60 years of age with current combat-related PTSD symptoms were randomized, using a 1:1 ratio in a parallel design, to active (rTMS+CPT) versus sham (sham+CPT) rTMS just prior to weekly CPT for 12-15 sessions...
March 15, 2018: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29344631/a-brief-exposure-based-treatment-vs-cognitive-processing-therapy-for-posttraumatic-stress-disorder-a-randomized-noninferiority-clinical-trial
#7
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
#8
COMMENT
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
#9
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...
December 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
#10
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...
December 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
#11
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
#12
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...
December 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
#13
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...
January 2018: 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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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