Intensive prolonged exposure treatment for adolescent complex posttraumatic stress disorder: a single-trial design.
Identifieur interne : 000B94 ( Main/Exploration ); précédent : 000B93; suivant : 000B95Intensive prolonged exposure treatment for adolescent complex posttraumatic stress disorder: a single-trial design.
Auteurs : Lotte Hendriks [Pays-Bas] ; Rianne A. De Kleine [Pays-Bas] ; Mieke Heyvaert [Belgique] ; Eni S. Becker [Pays-Bas] ; Gert-Jan Hendriks [Pays-Bas] ; Agnes Van Minnen [Pays-Bas]Source :
- Journal of child psychology and psychiatry, and allied disciplines [ 1469-7610 ] ; 2017.
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- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
Abstract
BACKGROUND
The current study evaluated the effectiveness and safety of intensive prolonged exposure (PE) targeting adolescent patients with complex posttraumatic stress disorder (PTSD) and comorbid disorders following multiple interpersonal trauma.
METHODS
Ten adolescents meeting full diagnostic criteria for PTSD were recruited from a specialized outpatient mental health clinic and offered a standardized intensive PE. The intensive PE consisted of three daily 90-min exposure sessions delivered on five consecutive weekdays, followed by 3 weekly 90-min booster sessions. In a single-trial design, the participants were randomly allocated to one of five baseline lengths (4-8 weeks) before starting the intensive PE. Before, during, and after intensive PE completion, self-reported PTSD symptom severity was assessed weekly as a primary outcome (a total of 21 measurements). Furthermore, clinician-administered PTSD diagnostic status and symptom severity (primary outcome), as well as self-reported comorbid symptoms (secondary outcomes), were assessed at four single time points (baseline-to-6-month follow-up).
RESULTS
Time-series analyses showed that self-reported PTSD symptom severity significantly declined following treatment (p = .002). Pre-postgroup analyses demonstrated significant reductions of clinician-administered PTSD symptom severity and self-reported comorbidity that persisted during the 3- and 6-month follow-ups (all ps < .05), where 80% of adolescents had reached diagnostic remission of PTSD. There was neither treatment dropout nor any adverse events.
CONCLUSIONS
The results of this first proof of concept trial suggest that intensive PE can be effective and safe in an adolescent population with complex PTSD, although the gains achieved need to be confirmed in a randomized controlled trial.
DOI: 10.1111/jcpp.12756
PubMed: 29057522
Affiliations:
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Becker</name><affiliation wicri:level="3"><nlm:affiliation>Behavioural Science Institute, NijCare, Radboud University, Nijmegen, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Behavioural Science Institute, NijCare, Radboud University, Nijmegen</wicri:regionArea><placeName><settlement type="city">Nimègue</settlement><region type="province" nuts="2">Gueldre</region></placeName></affiliation></author><author><name sortKey="Hendriks, Gert Jan" sort="Hendriks, Gert Jan" uniqKey="Hendriks G" first="Gert-Jan" last="Hendriks">Gert-Jan Hendriks</name><affiliation wicri:level="3"><nlm:affiliation>Overwaal Centre of Expertise for Anxiety Disorders, OCD and PTSD, Institution for Integrated Mental Health Care Pro Persona, Nijmegen, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Overwaal Centre of Expertise for Anxiety Disorders, OCD and PTSD, Institution for Integrated Mental Health Care Pro Persona, 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nuts="2">Gueldre</region></placeName></affiliation></author><author><name sortKey="Van Minnen, Agnes" sort="Van Minnen, Agnes" uniqKey="Van Minnen A" first="Agnes" last="Van Minnen">Agnes Van Minnen</name><affiliation wicri:level="3"><nlm:affiliation>Overwaal Centre of Expertise for Anxiety Disorders, OCD and PTSD, Institution for Integrated Mental Health Care Pro Persona, Nijmegen, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Overwaal Centre of Expertise for Anxiety Disorders, OCD and PTSD, Institution for Integrated Mental Health Care Pro Persona, Nijmegen</wicri:regionArea><placeName><settlement type="city">Nimègue</settlement><region type="province" nuts="2">Gueldre</region></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Behavioural Science Institute, NijCare, Radboud University, Nijmegen, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Behavioural Science Institute, NijCare, Radboud University, Nijmegen</wicri:regionArea><placeName><settlement type="city">Nimègue</settlement><region type="province" nuts="2">Gueldre</region></placeName></affiliation></author></analytic><series><title level="j">Journal of child psychology and psychiatry, and allied disciplines</title><idno type="eISSN">1469-7610</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>Female (MeSH)</term><term>Follow-Up Studies (MeSH)</term><term>Humans (MeSH)</term><term>Implosive Therapy (methods)</term><term>Male (MeSH)</term><term>Outcome Assessment, Health Care (MeSH)</term><term>Proof of Concept Study (MeSH)</term><term>Severity of Illness Index (MeSH)</term><term>Stress Disorders, Post-Traumatic (therapy)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Indice de gravité de la maladie (MeSH)</term><term>Mâle (MeSH)</term><term>Thérapie implosive (méthodes)</term><term>Troubles de stress post-traumatique (thérapie)</term><term>Étude de validation de principe (MeSH)</term><term>Études de suivi (MeSH)</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Implosive Therapy</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Thérapie implosive</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Stress Disorders, Post-Traumatic</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Troubles de stress post-traumatique</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Outcome Assessment, Health Care</term><term>Proof of Concept Study</term><term>Severity of Illness Index</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Femelle</term><term>Humains</term><term>Indice de gravité de la maladie</term><term>Mâle</term><term>Étude de validation de principe</term><term>Études de suivi</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>The current study evaluated the effectiveness and safety of intensive prolonged exposure (PE) targeting adolescent patients with complex posttraumatic stress disorder (PTSD) and comorbid disorders following multiple interpersonal trauma.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Ten adolescents meeting full diagnostic criteria for PTSD were recruited from a specialized outpatient mental health clinic and offered a standardized intensive PE. The intensive PE consisted of three daily 90-min exposure sessions delivered on five consecutive weekdays, followed by 3 weekly 90-min booster sessions. In a single-trial design, the participants were randomly allocated to one of five baseline lengths (4-8 weeks) before starting the intensive PE. Before, during, and after intensive PE completion, self-reported PTSD symptom severity was assessed weekly as a primary outcome (a total of 21 measurements). Furthermore, clinician-administered PTSD diagnostic status and symptom severity (primary outcome), as well as self-reported comorbid symptoms (secondary outcomes), were assessed at four single time points (baseline-to-6-month follow-up).</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Time-series analyses showed that self-reported PTSD symptom severity significantly declined following treatment (p = .002). Pre-postgroup analyses demonstrated significant reductions of clinician-administered PTSD symptom severity and self-reported comorbidity that persisted during the 3- and 6-month follow-ups (all ps < .05), where 80% of adolescents had reached diagnostic remission of PTSD. There was neither treatment dropout nor any adverse events.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>The results of this first proof of concept trial suggest that intensive PE can be effective and safe in an adolescent population with complex PTSD, although the gains achieved need to be confirmed in a randomized controlled trial.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">29057522</PMID><DateCompleted><Year>2018</Year><Month>06</Month><Day>05</Day></DateCompleted><DateRevised><Year>2019</Year><Month>12</Month><Day>10</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1469-7610</ISSN><JournalIssue CitedMedium="Internet"><Volume>58</Volume><Issue>11</Issue><PubDate><Year>2017</Year><Month>Nov</Month></PubDate></JournalIssue><Title>Journal of child psychology and psychiatry, and allied disciplines</Title><ISOAbbreviation>J Child Psychol Psychiatry</ISOAbbreviation></Journal><ArticleTitle>Intensive prolonged exposure treatment for adolescent complex posttraumatic stress disorder: a single-trial design.</ArticleTitle><Pagination><MedlinePgn>1229-1238</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1111/jcpp.12756</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The current study evaluated the effectiveness and safety of intensive prolonged exposure (PE) targeting adolescent patients with complex posttraumatic stress disorder (PTSD) and comorbid disorders following multiple interpersonal trauma.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Ten adolescents meeting full diagnostic criteria for PTSD were recruited from a specialized outpatient mental health clinic and offered a standardized intensive PE. The intensive PE consisted of three daily 90-min exposure sessions delivered on five consecutive weekdays, followed by 3 weekly 90-min booster sessions. In a single-trial design, the participants were randomly allocated to one of five baseline lengths (4-8 weeks) before starting the intensive PE. Before, during, and after intensive PE completion, self-reported PTSD symptom severity was assessed weekly as a primary outcome (a total of 21 measurements). Furthermore, clinician-administered PTSD diagnostic status and symptom severity (primary outcome), as well as self-reported comorbid symptoms (secondary outcomes), were assessed at four single time points (baseline-to-6-month follow-up).</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Time-series analyses showed that self-reported PTSD symptom severity significantly declined following treatment (p = .002). Pre-postgroup analyses demonstrated significant reductions of clinician-administered PTSD symptom severity and self-reported comorbidity that persisted during the 3- and 6-month follow-ups (all ps < .05), where 80% of adolescents had reached diagnostic remission of PTSD. There was neither treatment dropout nor any adverse events.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">The results of this first proof of concept trial suggest that intensive PE can be effective and safe in an adolescent population with complex PTSD, although the gains achieved need to be confirmed in a randomized controlled trial.</AbstractText><CopyrightInformation>© 2017 Association for Child and Adolescent Mental Health.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Hendriks</LastName><ForeName>Lotte</ForeName><Initials>L</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-5705-7345</Identifier><AffiliationInfo><Affiliation>Overwaal Centre of Expertise for Anxiety Disorders, OCD and PTSD, Institution for Integrated Mental Health Care Pro Persona, Nijmegen, The Netherlands.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Behavioural Science Institute, NijCare, Radboud University, Nijmegen, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>de Kleine</LastName><ForeName>Rianne A</ForeName><Initials>RA</Initials><AffiliationInfo><Affiliation>Overwaal Centre of Expertise for Anxiety Disorders, OCD and PTSD, Institution for Integrated Mental Health Care Pro Persona, Nijmegen, The Netherlands.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Institute of Psychology, Leiden University, Leiden, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Heyvaert</LastName><ForeName>Mieke</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Faculty of Psychology and Educational Sciences, Methodology of Educational Sciences Research Group, Catholic University of Leuven, Leuven, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Becker</LastName><ForeName>Eni S</ForeName><Initials>ES</Initials><AffiliationInfo><Affiliation>Behavioural Science Institute, NijCare, Radboud University, Nijmegen, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hendriks</LastName><ForeName>Gert-Jan</ForeName><Initials>GJ</Initials><AffiliationInfo><Affiliation>Overwaal Centre of Expertise for Anxiety Disorders, OCD and PTSD, Institution for Integrated Mental Health Care Pro Persona, Nijmegen, The Netherlands.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Behavioural Science Institute, NijCare, Radboud University, Nijmegen, The Netherlands.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>van Minnen</LastName><ForeName>Agnes</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Overwaal Centre of Expertise for Anxiety Disorders, OCD and PTSD, Institution for Integrated Mental Health Care Pro Persona, Nijmegen, The Netherlands.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Behavioural Science Institute, NijCare, Radboud University, Nijmegen, The Netherlands.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016430">Clinical Trial</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>06</Month><Day>14</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>J Child Psychol Psychiatry</MedlineTA><NlmUniqueID>0375361</NlmUniqueID><ISSNLinking>0021-9630</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007171" MajorTopicYN="N">Implosive Therapy</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017063" MajorTopicYN="Y">Outcome Assessment, Health Care</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000075082" MajorTopicYN="N">Proof of Concept Study</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012720" MajorTopicYN="N">Severity of Illness Index</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013313" MajorTopicYN="N">Stress Disorders, Post-Traumatic</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Complex PTSD</Keyword><Keyword MajorTopicYN="N">adolescents</Keyword><Keyword MajorTopicYN="N">intensive treatment</Keyword><Keyword MajorTopicYN="N">prolonged exposure</Keyword><Keyword MajorTopicYN="N">treatment outcome</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="accepted"><Year>2017</Year><Month>04</Month><Day>05</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>10</Month><Day>24</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>10</Month><Day>24</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2018</Year><Month>6</Month><Day>6</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">29057522</ArticleId><ArticleId IdType="doi">10.1111/jcpp.12756</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Belgique</li><li>Pays-Bas</li></country><region><li>Gueldre</li><li>Hollande-Méridionale</li></region><settlement><li>Leyde</li><li>Nimègue</li></settlement></list><tree><country name="Pays-Bas"><region name="Gueldre"><name sortKey="Hendriks, Lotte" sort="Hendriks, Lotte" uniqKey="Hendriks L" first="Lotte" last="Hendriks">Lotte Hendriks</name></region><name sortKey="Becker, Eni S" sort="Becker, Eni S" uniqKey="Becker E" first="Eni S" last="Becker">Eni S. Becker</name><name sortKey="De Kleine, Rianne A" sort="De Kleine, Rianne A" uniqKey="De Kleine R" first="Rianne A" last="De Kleine">Rianne A. De Kleine</name><name sortKey="De Kleine, Rianne A" sort="De Kleine, Rianne A" uniqKey="De Kleine R" first="Rianne A" last="De Kleine">Rianne A. De Kleine</name><name sortKey="Hendriks, Gert Jan" sort="Hendriks, Gert Jan" uniqKey="Hendriks G" first="Gert-Jan" last="Hendriks">Gert-Jan Hendriks</name><name sortKey="Hendriks, Gert Jan" sort="Hendriks, Gert Jan" uniqKey="Hendriks G" first="Gert-Jan" last="Hendriks">Gert-Jan Hendriks</name><name sortKey="Hendriks, Gert Jan" sort="Hendriks, Gert Jan" uniqKey="Hendriks G" first="Gert-Jan" last="Hendriks">Gert-Jan Hendriks</name><name sortKey="Hendriks, Lotte" sort="Hendriks, Lotte" uniqKey="Hendriks L" first="Lotte" last="Hendriks">Lotte Hendriks</name><name sortKey="Van Minnen, Agnes" sort="Van Minnen, Agnes" uniqKey="Van Minnen A" first="Agnes" last="Van Minnen">Agnes Van Minnen</name><name sortKey="Van Minnen, Agnes" sort="Van Minnen, Agnes" uniqKey="Van Minnen A" first="Agnes" last="Van Minnen">Agnes Van Minnen</name></country><country name="Belgique"><noRegion><name sortKey="Heyvaert, Mieke" sort="Heyvaert, Mieke" uniqKey="Heyvaert M" first="Mieke" last="Heyvaert">Mieke Heyvaert</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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