Comparative study of group treatments for posttraumatic stress disorder.

Abstract

Presented herein is a comparative study of group treatments for posttraumatic stress disorder (PTSD). In this study, an emerging intervention, memory specificity training (MeST), was compared with cognitive processing therapy (CPT) using standardized outcome measures of target symptoms (i.e., anxiety and depression from client perspective; memory specificity from independent rater perspective) and global functioning (independent rater perspective), as well as a process measure of expectancy (client perspective). Clients were assessed on 3 separate occasions: at baseline, posttreatment, and 3 months posttreatment. Adherence and treatment fidelity (independent rater perspective) were monitored throughout the course of both treatment conditions. Improvement in PTSD symptoms, depressive symptoms, and global functioning were similar between MeST and CPT; an increase in ability to specify memories upon retrieval was also similar between MeST and CPT. Positive reliable change was observed in both groups on all outcome measures. With respect to the primary target of PTSD symptoms, 88% of participants in both treatment groups moved into the functional distribution by posttreatment and maintained these gains at follow-up. Notably, compared with CPT, MeST required only half the dosage (i.e., number of sessions) to accomplish these gains. Illustrative vignettes from client-therapist exchanges are provided, and results are discussed in terms of the potential mechanisms of action. Implications for both clinical practice and clinical research are also included. (PsycINFO Database Record

A study protocol for a randomised trial of adjunct computerised memory specificity training (c-MeST) for major depression in youth: targeting cognitive mechanisms to enhance usual care outcomes in mental health settings

“…MeST has been shown to lead to significant improvements in the retrieval of specific memories that is sustained over time [20][21][22][23]. Crucially, it also produces significant reductions in depressive symptoms in clinical samples [21][22][23][24]. Recently, a computerised format of MeST (c-MeST) has been developed, which provides an easily accessible, low cost option for improving memory specificity [25,26].…”

The transportability of Memory Specificity Training (MeST): adapting an intervention derived from experimental psychology to routine clinical practices

“…In subsequent studies a fifth [16,25] and sixth session [26] were introduced where participants were invited to conduct exercises based on the STOPmodel; they were instructed to think back and write down when they were thinking at an overgeneral level, describe which specific event prompted the overgeneral thinking (as detailed as possible) and come up with and write down an opposite example. Two other new elements were added: a revision and take-home-message in the last session and in the last session homework exercises are provided so participants can continue to train further.…”

“…MeST was found to lead to an increase in memory specificity and improvements in associated cognitive processes (problem solving, rumination and hopelessness) in 10 depressed female inpatients. Although many existing MeST trials have methodological limitations and do not always show positive effects on symptomatology, subsequent investigations with MeST have shown positive results indicating that memory specificity is modifiable and such modification in turn affects the symptoms of emotional disorders and other cognitive processes (such as rumination) that mediate the association between rAMS and emotional disorder [16][17][18][19][20].…”

“…In total, participants are offered 104 cue word exercises in this version of MeST. In subsequent studies a fifth [16,25] and sixth [26] session were introduced. An implicit assumption underlying these adaptions is that more exercises are required, although this assumption has not been tested.…”

Remediating reduced memory specificity in bipolar disorder: A case study using a Computerized Memory Specificity Training

“…The authors of these reviews reported that no studies have yet examined the impact of a memory‐therapeutic intervention among people with BD. One intervention, Memory Specificity Training (MeST) (Raes, Williams, et al, ), is regarded as a promising method for improving memory specificity and remediating related symptoms and processes in UD (Eigenhuis, Seldenrijk, Schaik, Raes, & Oppen, ; Raes, Williams, et al, ; Werner‐Seidler et al, ), PTSD (Maxwell et al, ), and Schizophrenia (Blairy et al, ; Ricarte, Hernández‐Viadel, Latorre, & Ros, ). A recent meta‐analysis confirms these effects (Barry et al, ) and concluded that MeST has also been found to improve other processes associated with rAMS, such as deficits in problem solving, future‐oriented thinking, and hopelessness.…”