Comparative effectiveness of group v. individual trauma-focused treatment for posttraumatic stress disorder in veterans.
Psychol Med
; 53(10): 4561-4568, 2023 07.
Article
em En
| MEDLINE
| ID: mdl-35959560
ABSTRACT
BACKGROUND:
Cognitive processing therapy (CPT) and prolonged exposure (PE) delivered in an individual setting are efficacious and effective treatments for veterans with posttraumatic stress disorder (PTSD). Group CPT has been shown to be less efficacious than individual CPT, however, evidence regarding real-world effectiveness is limited.METHODS:
We conducted a retrospective, observational, comparative effectiveness study including veterans that received at least eight sessions of group CPT, individual CPT, or individual PE, and were discharged from PTSD residential treatment at the Department of Veterans Affairs between 1 October 2015, and 30 September 2020. PTSD symptom severity was assessed with the PTSD Checklist for DSM-5 (PCL-5) and treatments delivered in a group (CPT) or individual (CPT or PE) setting were compared at discharge and 4-month post-discharge follow-up.RESULTS:
Of 6735 veterans, 3888 [653 women (17%), median (IQR) age 45 (35-55) years] received individual and 2847 [206 women (7.2%), median (IQR) age 42 (34-54)] received group therapy. At discharge, improvement in PTSD severity was statistically greater among those treated individually (mean difference on the PCL-5, 2.55 (95% CI 1.61-3.49); p = <0.001]. However, the difference was smaller than the minimal clinically important difference of 7.9 points. The groups did not differ significantly at 4-month follow-up [mean difference on the PCL-5, 0.37 (95% CI -0.86 to 1.60); p = 0.551].CONCLUSION:
Group CPT was associated with a slightly smaller reduction of PTSD symptom severity than individual CPT or PE in veterans at the end of residential treatment. There were no differences at 4-month follow-up.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
11_ODS3_cobertura_universal
Problema de saúde:
11_delivery_arrangements
Assunto principal:
Transtornos de Estresse Pós-Traumáticos
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Veteranos
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Terapia Cognitivo-Comportamental
Limite:
Adult
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
Psychol Med
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Estados Unidos