학술논문
Change in posttraumatic stress disorder-related thoughts during treatment: Do thoughts drive change when pills are involved?
Document Type
Academic Journal
Author
Rauch SAM; Atlanta VA Healthcare System, Mental Health Service Line, Decatur, Georgia, USA.; School of Medicine, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA.; Kim HM; VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.; University of Michigan, Consulting for Statistics, Computing, and Analytics Research, Ann Arbor, Michigan, USA.; Venners MR; VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.; Porter KE; VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.; Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.; Norman SB; National Center for PTSD, White River Junction, Vermont, USA.; VA Center of Excellence for Stress and Mental Health, San Diego, California, USA.; School of Medicine, University of California, San Diego, La Jolla, California, USA.; Simon NM; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.; Department of Psychiatry, New York University Grossman School of Medicine, New York, New York, USA.; Rothbaum BO; School of Medicine, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA.; Tuerk PW; Department of Human Services, University of Virginia, Charlottesville, Virginia, USA.; Acierno RE; Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA.; Louis A. Faillace Department of Psychiatry, the University of Texas Health Science Center, Houston, USA.; Bui E; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.; University of Caen Normandy and Caen University Hospital, Caen, France.; Powell C; University of Michigan, Consulting for Statistics, Computing, and Analytics Research, Ann Arbor, Michigan, USA.; Smith ER; VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.; Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.; Goetter E; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.; McSweeney LB; National Center for PTSD, Women's Health Science Division, VA Boston Healthcare System, Boston, Massachusetts, USA.
Source
Publisher: Wiley Country of Publication: United States NLM ID: 8809259 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-6598 (Electronic) Linking ISSN: 08949867 NLM ISO Abbreviation: J Trauma Stress Subsets: MEDLINE
Subject
Language
English
Abstract
Posttraumatic negative thoughts about one's self and the world are related to posttraumatic stress disorder (PTSD) symptom severity and change in cognitive behavioral treatment (CBT), but little is known about this association when CBT is delivered with medication. The current study presents a planned comparison of changes in negative posttraumatic thoughts during (a) prolonged exposure (PE) plus pill placebo (PE+PLB), (b) sertraline plus enhanced medication management (SERT+EMM), and (c) PE plus sertraline (PE+SERT) as part of a randomized clinical trial in a sample of 176 veterans. Lagged regression modeling revealed that change in posttraumatic negative thoughts was associated with PTSD symptom change in the conditions in which participants received sertraline, ds = 0.14-0.25, ps = 0.04-.001). However, contrary to previous research, the models that started with symptom change were also statistically significant, d = 0.23, p < .001, for the lagged effect of symptoms on negative thoughts about self in the SERT+EMM condition, indicating a bidirectional association between such thoughts and PTSD symptoms. In the PE+PLB condition, no significant association between posttraumatic thoughts and PTSD symptoms emerged in either direction. These results suggest that the previously demonstrated role of change in posttraumatic thoughts leading to PTSD symptom reduction in PE may be altered when combined with pill administration, either active or placebo.
(© 2021 International Society for Traumatic Stress Studies.)
(© 2021 International Society for Traumatic Stress Studies.)