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标题：Effect of Prolonged Exposure, intensified Prolonged Exposure and STAIR Prolonged Exposure in patients with PTSD related to childhood abuse: a randomized controlled trial
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作者：Danielle A. C. Oprel ; Chris M. Hoeboer ; Maartje Schoorl 等
期刊名称：European Journal of Psychotraumatology
印刷版ISSN：2000-8198
电子版ISSN：2000-8066
出版年度：2021
卷号：12
期号：1
页码：1851511-1851524
DOI：10.1080/20008198.2020.1851511
出版社：Taylor & Francis Group
摘要：Background: It is unclear whether the evidence-based treatments for PTSD are as effective in patients with CA-PTSD. Objective: We aimed to investigate the effectiveness of three variants of prolonged exposure therapy. Method: We recruited adults with CA-PTSD. Participants were randomly assigned to Prolonged Exposure (PE; 16 sessions in 16 weeks), intensified Prolonged Exposure (iPE; 12 sessions in 4 weeks followed by 2 booster sessions) or a phase-based treatment, in which 8 sessions of PE were preceded by 8 sessions of Skills Training in Affective and Interpersonal Regulation (STAIR+PE; 16 sessions in 16 weeks). Assessments took place in week 0 (baseline), week 4, week 8, week 16 (post-treatment) and at a 6-and 12-month follow-up. The primary outcome was clinician-rated PTSD symptom severity. Results: We randomly assigned 149 patients to PE (48), iPE (51) or STAIR+PE (50). All treatments resulted in large improvements in clinician assessed and self-reported PTSD symptoms from baseline to 1-year follow-up (Cohen’s d > 1.6), with no significant differences among treatments. iPE led to faster initial symptom reduction than PE for self-report PTSD symptoms (t135 = −2.85, p = .005, d = .49) but not clinician-assessed symptoms (t135 = −1.65, p = .10) and faster initial symptom reduction than STAIR+PE for self-reported (t135 = −4.11, p < .001, d = .71) and clinician-assessed symptoms (t135 = −2.77, p = .006, Cohen’s d = .48) STAIR+PE did not result in significantly more improvement from baseline to 1-year follow-up on the secondary outcome emotion regulation, interpersonal problems and self-esteem compared to PE and iPE. Dropout rates did not differ significantly between conditions. Conclusions: Variants of exposure therapy are tolerated well and lead to large improvements in patients with CA-PTSD. Intensifying treatment may lead to faster improvement but not to overall better outcomes.
关键词：Posttraumatic stress disorder CA-PTSD trauma-focused treatment childhood trauma prolonged exposure STAIR intensified treatment