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Veterans receiving a second course of cognitive processing therapy or prolonged exposure therapy: is it better to switch or stay the same?

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Title: Veterans receiving a second course of cognitive processing therapy or prolonged exposure therapy: is it better to switch or stay the same?
Authors: Holder, Nicholas (AUTHOR), Batten, Adam J. (AUTHOR), Shiner, Brian (AUTHOR), Li, Yongmei (AUTHOR), Madden, Erin (AUTHOR), Neylan, Thomas C. (AUTHOR), Seal, Karen H. (AUTHOR), Patterson, Olga V. (AUTHOR), DuVall, Scott L. (AUTHOR), Maguen, Shira (AUTHOR)
Source: Cognitive Behaviour Therapy. Nov2022, Vol. 51 Issue 6, p456-469. 14p. 3 Charts, 1 Graph.
Subjects: Exposure therapy, Cognitive therapy, United States. Veterans Health Administration, Post-traumatic stress disorder, Afghan War, 2001-2021, Veterans, Veterans' health, Transposition of great vessels
Geographic Terms: Afghanistan, Iraq
Abstract: Cognitive processing therapy (CPT) and prolonged exposure therapy (PE) are effective psychotherapies for post-traumatic stress disorder (PTSD). However, these treatments also have high rates of dropout and non-response. Therefore, patients may need a second course of treatment. We compared outcomes for patients who switched between CPT/PE and those who repeated CPT/PE during a second course of treatment. We collected data from Iraq and Afghanistan war veterans (n = 2,958) who received a second course of CPT/PE in the Veterans Health Administration from 2001 to 2017 and had symptom outcomes (PTSD checklist; PCL). We measured the association between treatment sequence and change in PCL score over the second course of treatment using hierarchical Bayesian regression, adjusted for sociodemographic and clinical characteristics. All treatment sequences showed a significant reduction in PCL score over time (β = −4.80; HDI95: −5.74, −3.86). Veterans who switched from CPT to PE had modestly greater PCL reductions during the second course than those who repeated CPT. However, no significant difference in PCL change during the second course was observed between veterans who repeated PE and those who switched from PE to CPT. Veterans participating in a second course of CPT/PE can benefit, and switching treatment may be slightly more beneficial following CPT. [ABSTRACT FROM AUTHOR]
Copyright of Cognitive Behaviour Therapy is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Veterans receiving a second course of cognitive processing therapy or prolonged exposure therapy: is it better to switch or stay the same?
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  Data: <searchLink fieldCode="JN" term="%22Cognitive+Behaviour+Therapy%22">Cognitive Behaviour Therapy</searchLink>. Nov2022, Vol. 51 Issue 6, p456-469. 14p. 3 Charts, 1 Graph.
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  Data: <searchLink fieldCode="DE" term="%22Afghanistan%22">Afghanistan</searchLink><br /><searchLink fieldCode="DE" term="%22Iraq%22">Iraq</searchLink>
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  Data: Cognitive processing therapy (CPT) and prolonged exposure therapy (PE) are effective psychotherapies for post-traumatic stress disorder (PTSD). However, these treatments also have high rates of dropout and non-response. Therefore, patients may need a second course of treatment. We compared outcomes for patients who switched between CPT/PE and those who repeated CPT/PE during a second course of treatment. We collected data from Iraq and Afghanistan war veterans (n = 2,958) who received a second course of CPT/PE in the Veterans Health Administration from 2001 to 2017 and had symptom outcomes (PTSD checklist; PCL). We measured the association between treatment sequence and change in PCL score over the second course of treatment using hierarchical Bayesian regression, adjusted for sociodemographic and clinical characteristics. All treatment sequences showed a significant reduction in PCL score over time (β = −4.80; HDI95: −5.74, −3.86). Veterans who switched from CPT to PE had modestly greater PCL reductions during the second course than those who repeated CPT. However, no significant difference in PCL change during the second course was observed between veterans who repeated PE and those who switched from PE to CPT. Veterans participating in a second course of CPT/PE can benefit, and switching treatment may be slightly more beneficial following CPT. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Cognitive Behaviour Therapy is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=159023034
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      – Type: doi
        Value: 10.1080/16506073.2022.2058996
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      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 14
        StartPage: 456
    Subjects:
      – SubjectFull: Exposure therapy
        Type: general
      – SubjectFull: Cognitive therapy
        Type: general
      – SubjectFull: United States. Veterans Health Administration
        Type: general
      – SubjectFull: Post-traumatic stress disorder
        Type: general
      – SubjectFull: Afghan War, 2001-2021
        Type: general
      – SubjectFull: Veterans
        Type: general
      – SubjectFull: Veterans' health
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      – SubjectFull: Transposition of great vessels
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      – SubjectFull: Afghanistan
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      – SubjectFull: Iraq
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      – TitleFull: Veterans receiving a second course of cognitive processing therapy or prolonged exposure therapy: is it better to switch or stay the same?
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              Text: Nov2022
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