Predictors and moderators of treatment outcomes in phase-based treatment and trauma-focused treatments in patients with childhood abuse-related post-traumatic stress disorder
This study investigated the relationship between PTSD and a history of childhood abuse, and whether symptoms predicted or moderated treatment outcomes.
Article Abstract
“Background: Knowledge of treatment predictors and moderators is important for improving the effectiveness of treatment for PTSD due to childhood abuse.
Objective: The first aim of this study was to test the potential predictive value of variables commonly associated with PTSD resulting from a history of repeated childhood abuse, in relation to treatment outcomes. The second aim was to examine if complex PTSD symptoms act as potential moderators between treatment conditions and outcomes.
Method: Data were obtained from a randomized controlled trial comparing a phase-based treatment (Skills Training in Affect and Interpersonal Regulation [STAIR] followed by Eye Movement Desensitization and Reprocessing [EMDR] therapy; n = 57) with a direct trauma-focused treatment (EMDR therapy only; n = 64) in people with PTSD due to childhood abuse. The possible predictive effects of the presence of borderline personality disorder, dissociative symptoms, and suicidal and self-injurious behaviours were examined. In addition, it was determined whether symptoms of emotion regulation difficulties, self-esteem, and interpersonal problems moderated the relation between the treatment condition and PTSD post-treatment, corrected for pre-treatment PTSD severity.
Results: Pre-treatment PTSD severity proved to be a significant predictor of less profitable PTSD treatment outcomes. The same was true for the severity of dissociative symptoms, but only post-treatment, and not when corrected for false positives. Complex PTSD symptoms did not moderate the relationship between the treatment conditions and PTSD treatment outcomes.
Conclusions: The current findings suggest that regardless of the common comorbid symptoms studied, immediate trauma-focused treatment is a safe and effective option for individuals with childhood-related PTSD. However, individuals experiencing severe symptoms of PTSD may benefit from additional treatment sessions or the addition of other evidence-based PTSD treatment approaches. The predictive influence of dissociative sequelae needs further research.
The study design was registered in The Dutch trial register (https://www.trialregister.nl/trialreg/admin/rctview.asp?TC = 5991) NTR5991 and was approved by the medical ethics committee of Twente NL 56641.044.16 CCMO.
Highlights:
- One of first studies that aimed to identify multiple potential predictors and moderators in patients with PTSD related to childhood abuse.
- Only severe PTSD predicted worse treatment outcomes.
- The predictive influence of dissociative sequelae needs further research.”
—Description from publisher
Article Access
Open Access
van Vliet, N. I., Huntjens, R. J. C., Van Dijk, M. K., Huisman, M., Bachrach, N., Meewisse, M-L., van Haren, S., & de Jongh, A. (2024). Predictors and moderators of treatment outcomes in phase-based treatment and trauma-focused treatments in patients with childhood abuse-related post-traumatic stress disorder. European Journal of Psychotraumatology, 15: 2300589. Open access: https://doi.org/10.1080/20008066.2023.2300589
Date
January 17, 2024
Creator(s)
Noortje I. van Vliet, Rafaele J. C. Huntjens, Maarten K. van Dijk
Contributor(s)
Mark Huisman, Nathan Bachrach, Marie-Louise Meewissef, Sietske van Hareng, Ad de Jongh
Topics
Childhood Trauma, Complex Trauma/C-PTSD, PTSD
Extent
12 pages
Publisher
Taylor & Francis
Rights
© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
APA Citation
van Vliet, N. I., Huntjens, R. J. C., Van Dijk, M. K., Huisman, M., Bachrach, N., Meewisse, M-L., van Haren, S., & de Jongh, A. (2024). Predictors and moderators of treatment outcomes in phase-based treatment and trauma-focused treatments in patients with childhood abuse-related post-traumatic stress disorder. European Journal of Psychotraumatology, 15: 2300589. Open access: https://doi.org/10.1080/20008066.2023.2300589
Audience
EMDR Therapists, Other Mental Health Professionals
Language
English
Content Type
Article, Peer-Reviewed
Access Type
External Resource, Open Access