Predicting optimal treatment outcomes in phase‐based treatment and direct trauma‐focused treatment among patients with posttraumatic stress disorder stemming from childhood abuse

Author:

Bremer Susanne1,van Vliet Noortje I.1ORCID,Van Bronswijk Suzanne23,Huntjens Rafaele4,de Jongh Ad567,van Dijk Maarten K.1

Affiliation:

1. Dimence Mental Health Group Deventer the Netherlands

2. Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences Maastricht University Maastricht the Netherlands

3. Department of Psychiatry and Psychology Maastricht University Medical Center Maastricht the Netherlands

4. Department of Experimental Psychotherapy and Psychopathology University of Groningen Groningen the Netherlands

5. Department of Social Dentistry and Behavioral Sciences University of Amsterdam and Vrije Universiteit Amsterdam the Netherlands

6. School of Health Sciences Salford University Manchester UK

7. Institute of Health and Society University of Worcester UK

Abstract

AbstractResearch over the last few decades has demonstrated the effectiveness of various treatments for posttraumatic stress disorder (PTSD). However, the question of which treatment works best remains, especially for patients with PTSD stemming from childhood abuse. Using the Personalized Advantage Index (PAI), we explored which patients benefit more from phase‐based treatment and which benefit more from direct trauma‐focused treatment. Data were obtained from a multicenter randomized controlled trial (RCT) comparing a phase‐based treatment condition (i.e., eye‐movement desensitization and reprocessing [EMDR] therapy preceded by Skills Training in Affect and Interpersonal Regulation [STAIR]; n = 57) and a direct trauma‐focused treatment (EMDR only; n = 64) among individuals with PTSD related to childhood abuse. Machine learning techniques were used to examine all pretreatment variables included in the trial as potential predictors and moderators, with selected variables combined to build the PAI model. The utility of the PAI was tested by comparing actual posttreatment outcomes of individuals who received PAI‐indicated treatment with those allocated to a non–PAI‐indicated treatment. Although eight pretreatment variables between PTSD treatment outcome and treatment condition were selected as moderators, there was no significant difference between participants assigned to their PAI‐indicated treatment and those randomized to a non–PAI‐indicated treatment, d = 0.25, p = .213. Hence, the results of this study do not support the need for personalized medicine for patients with PTSD and a history of childhood abuse. Further research with larger sample sizes and external validation is warranted.

Funder

Stichting tot Steun Vereniging tot Christelijke Verzorging van Geestes- en Zenuwzieken

Publisher

Wiley

Subject

Psychiatry and Mental health,Clinical Psychology

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