Abstract:
BACKGROUND:Understanding cognitive and biological mechanisms of PTSD treatment can help refine treatments and increase rates of response. METHODS:Thirty-six veterans with PTSD were randomly assigned to receive Prolonged exposure therapy (PE) or Present-Centered therapy (PCT). We examined symptoms, trauma-related cognitions, and two indices of HPA axis function (cortisol awakening response and cortisol response to a script-driven imagery task). RESULTS:Thirty veterans started treatment and 26 completed. PE resulted in significantly more symptom reduction than PCT (P = .008). High treatment responders collapsed across treatments showed nominally higher cortisol levels measured at pretreatment 30 min after trauma script exposure compared to low responders (P = .08). At midtreatment, high treatment responders showed higher cortisol levels throughout the imagery task (Ps = .03-.04). There were no differences between high and low treatment responders at posttreatment. Thoughts of incompetence (F (1.6, 35.8) = 16.8, P = .000) and a dangerous world (F (1.3, 29.9) = 8.2, P = .004) significantly improved over time in high treatment responders but showed no change in low responders. Script-associated cortisol response prior to treatment and reductions in thoughts of incompetence accounted for 83% of the variance in reductions in PTSD severity with PE. CONCLUSIONS:Both increased cortisol response to personal trauma script prior to PTSD therapy and reductions in cognitive symptoms of PTSD were significantly and uniquely related to reductions in the core symptoms of PTSD in PE. However, contrary to our hypotheses, cortisol measures were not related to cognitive changes.
journal_name
Depress Anxietyjournal_title
Depression and anxietyauthors
Rauch SA,King AP,Abelson J,Tuerk PW,Smith E,Rothbaum BO,Clifton E,Defever A,Liberzon Idoi
10.1002/da.22331subject
Has Abstractpub_date
2015-03-01 00:00:00pages
204-12issue
3eissn
1091-4269issn
1520-6394journal_volume
32pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Adolescent depression may increase risk for poor mental health outcomes in adulthood. The objective of this study was to systematically review the literature on the association between adolescent depression and adult anxiety and depressive disorders as well as suicidality. METHODS:EMBASE, MEDLINE, and PSYCi...
journal_title:Depression and anxiety
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journal_title:Depression and anxiety
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journal_title:Depression and anxiety
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journal_title:Depression and anxiety
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journal_title:Depression and anxiety
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pub_type: 杂志文章,多中心研究,随机对照试验
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