Special cognitive therapy benefits youth with abuse-related PTSD

  • Rosner R & al.
  • JAMA Psychiatry
  • 10 Apr 2019

  • International Clinical Digest
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Takeaway

  • Adolescents and young adults with child sexual or physical abuse-related PTSD who received developmentally adapted cognitive processing therapy (D-CPT) had a significantly greater decrease in PTSD severity than those in the waitlist group with treatment advice (WL/TA).

Why this matters

  • Evidence-based data on treatment for abuse-related PTSD in adolescents are lacking even though 31% of adolescents with a history of physical abuse and 41% of adolescent rape survivors are estimated to have PTSD.

Study design

  • 88 adolescents and young adults (age, 14-21 years) with childhood abuse-related PTSD were randomly assigned to D-CPT or WL/TA.
  • Funding: German Federal Ministry of Education and Research.

Key results

  • D-CPT was associated with greater improvement in PTSD severity vs WL/TA (mean CAPS-CA scores, 24.7 vs 47.5; Hedges' g=0.90).
    • This difference was maintained at 3-month follow-up (mean CAPS-CA scores, 25.9 vs 47.3; Hedges' g=0.80).
  • Self-reported PTSD symptom severity improved with D-CPT vs WL/TA at:
    • posttreatment assessment (mean scores, 18.1 vs 35.1; Hedges' g=1.08) and
    • follow-up assessment (mean scores, 16.1 vs 36.1; Hedges' g=1.35).
  • Treatment success was greatest during the trauma-focused core phase.
  • D-CPT was associated with more stable treatment gains with effect size:
    • 0.65-0.98 at posttreatment assessment and
    • 0.74-1.00 at follow-up assessment.

Limitations

  • Small study sample.

Coauthored with Antara Ghosh, PhD 

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