Predictors of dropout from a randomized clinical trial of cognitive processing therapy for female veterans with military sexual trauma-related PTSD

Holder, Nicholas; Holliday, Ryan; Wiblin, Jessica; LePage, James P.; Surís, Alina

doi:10.1016/j.psychres.2019.04.022

Cited by 16 publications

(22 citation statements)

References 51 publications

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“…All studies delivered interventions face-to-face (two did not explicitly specify, but are strongly inferred due to context). Whilst two studies used a fixed treatment duration (12–13 h; Holder et al, 2019 ; Lester et al, 2010 ), the remainder offered more variable treatment duration. There were no co-interventions specified by any study.…”

Section: Resultsmentioning

confidence: 99%

“…Although only one study reported the required controlled effect size statistics (Lester et al, 2010), after contacting remaining authors by email, two further authors provided the required data (Binnie & Boden, 2016;Holder et al, 2019). An overall meta-analysis of controlled effects of deprivation on dropout was performed using the three studies with relevant data (Binnie & Boden, 2016;Holder et al, 2019;Lester et al, 2010). As Lester et al (2010) analysed both education and household income, two alternative analyses were performed (Fig.…”

Section: Meta-analysismentioning

confidence: 99%

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Socioeconomic Deprivation and Dropout from Contemporary Psychological Intervention for Common Mental Disorders: A Systematic Review

Firth

Barkham

Delgadillo

et al. 2021

Adm Policy Ment Health

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Dropout during psychological intervention is a significant problem. Previous evidence for associations with socioeconomic deprivation is mixed. This study aimed to review the evidence for associations between deprivation and dropout from contemporary adult psychological interventions for common mental disorders (CMDs). Systematic review, narrative synthesis and random effects meta-analysis of peer-reviewed English language journal articles published June 2010–June 2020 was conducted. Data sources included medline, PsycInfo, databases indexed by web of science, ProQuest social science database and sociology collection, and the Cochrane Library, supplemented by forward and backward citation searching. Five studies were eligible for inclusion (mean N = 170, 68% female, 60% White Caucasian, 32% dropout rate, predominantly cognitive behaviour therapy/cognitive processing therapy). Narrative synthesis indicated an overall non-significant effect of deprivation on dropout. Meta-analytic significance of controlled (k = 3) and uncontrolled (k = 4) effects depended on the measure of deprivation included for those studies using more than one measure (controlled OR 1.21–1.32, p = 0.019–0.172, uncontrolled OR 1.28–1.76, p = 0.024–0.423). The low number of included studies meant sub-group comparisons were limited, despite some tentative indications of potential differential effects. A comparator set of excluded studies showed similar uncertainty. There was limited evidence that did not overall suggest a clear significant effect of deprivation on dropout from contemporary individual CMD interventions. However, more contemporary research is needed, as effects may vary according to clinical and methodological factors, and for dropout versus non-initiation.

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Section: Resultsmentioning

confidence: 99%

Section: Meta-analysismentioning

confidence: 99%

Socioeconomic Deprivation and Dropout from Contemporary Psychological Intervention for Common Mental Disorders: A Systematic Review

Firth

Barkham

Delgadillo

et al. 2021

Adm Policy Ment Health

View full text Add to dashboard Cite

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“…However, constructs related to those within TPB have been linked to psychotherapy adherence for individuals with PTSD (e.g., Britt et al., 2011; Schottenbauer et al., 2008; Spoont et al., 2014; Taylor, 2003; Taylor et al., 2012; Westra et al., 2007). For example, constructs related to the TPB attitudes construct, such as motivation, treatment credibility, and treatment expectancies, were shown to predict CPT dropout among female survivors of military sexual assault (Holder et al., 2019; note that the associations were nonsignificant in multivariate models), dropout from a combination of PTSD treatments (Taylor, 2003), and adherence to cognitive behavioral therapy for anxiety disorders (Taylor et al., 2012; Westra et al., 2007). In recent qualitative work, Hundt and colleagues (2018) reported that a lack of buy‐in to the treatment rationale and beliefs that the treatment was failing were among the reasons veterans cited for dropping out of CPT/PE; veterans in this study also related dropout to practical barriers to participation, a construct related to PBC.…”

Section: Theory Of Planned Behavior Scale Measure Attitudes Participamentioning

confidence: 99%

A Theory of Planned Behavior Scale for Adherence to Trauma‐Focused Posttraumatic Stress Disorder Treatments

Meis

Noorbaloochi

Campbell

et al. 2020

Journal of Traumatic Stress

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Evidence‐based psychotherapies for posttraumatic stress disorder (PTSD), such as cognitive processing therapy and prolonged exposure (CPT/PE), greatly reduce suffering for veterans, but many veterans fail to complete treatment. Developing a theory‐based understanding of adherence is necessary to inform interventions to improve treatment retention. We developed and tested a series of scales applying the theory of planned behavior (TPB) to CPT/PE adherence. The scales were administered in mailed surveys as part of a larger mixed‐methods study of veteran adherence to PE/CPT. Surveys were sent to 379 veterans who were initiating CPT/PE across four U.S. Veterans Affairs (VA) hospitals and 207 of their loved ones. Subsequent session attendance and homework compliance were coded via a review of electronic medical records. We examined item‐level characteristics, factor structure, and the convergent and discriminant validity of the resultant scales. The findings support four subscales: two related to attitudes (i.e., Treatment Makes Sense and Treatment Fits Needs), one related to perceived behavioral control over participation (i.e., Participation Control), and one related to perceived family attitudes about CPT/PE participation (i.e., Subjective Norms). Scale validity was supported through significant associations with theoretically relevant constructs, including intentions to persist in CPT/PE, rs = .19–.38; treatment completion, rs = .21–.25; practical treatment barriers, rs = −.19 to −.24; and therapeutic alliance, rs = .39–.57.

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“…The prevalence of PTSD in the general population of the United States is estimated at nearly 9% (American Psychiatric Association, 2013), but ranges from 10 to 30% for US veterans (Kang, Natelson, Mahan, Lee, & Murphy, 2003). Active‐duty military personnel and veterans suffering with PTSD are often reluctant to enroll or simply fail to respond to currently available psychotherapies (Holder, Holliday, Wiblin, LePage, & Suris, 2019; Lewis, Roberts, Gibson, & Bisson, 2020) and pharmacotherapies (Sullivan & Neria, 2009). One novel alternative and complementary treatment for PTSD is equine‐assisted therapy (EAT) (Bachi, Terkel, & Teichman, 2012; Selby & Smith‐Osborne, 2013).…”

Section: Introductionmentioning

confidence: 99%

Neural changes following equine‐assisted therapy for posttraumatic stress disorder: A longitudinal multimodal imaging study

Lee

Suarez‐Jimenez

Zilcha‐Mano

et al. 2021

Human Brain Mapping

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Background While effective treatments for posttraumatic stress disorder (PTSD) exist, many individuals, including military personnel and veterans fail to respond to them. Equine‐assisted therapy (EAT), a novel PTSD treatment, may complement existing PTSD interventions. This study employs longitudinal neuro‐imaging, including structural magnetic resonance imaging (sMRI), resting state‐fMRI (rs‐fMRI), and diffusion tensor imaging (DTI), to determine mechanisms and predictors of EAT outcomes for PTSD. Method Nineteen veterans with PTSD completed eight weekly group sessions of EAT undergoing multimodal MRI assessments before and after treatment. Clinical assessments were conducted at baseline, post‐treatment and at 3‐month follow‐up. Results At post‐treatment patients showed a significant increase in caudate functional connectivity (FC) and reduction in the gray matter density of the thalamus and the caudate. The increase of caudate FC was positively associated with clinical improvement seen immediately at post‐treatment and at 3‐month follow‐up. In addition, higher baseline caudate FC was associated with greater PTSD symptom reduction post‐treatment. Conclusions This exploratory study is the first to demonstrate that EAT can affect functional and structural changes in the brains of patients with PTSD. The findings suggest that EAT may target reward circuitry responsiveness and produce a caudate pruning effect from pre‐ to post‐treatment.

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Predictors of dropout from a randomized clinical trial of cognitive processing therapy for female veterans with military sexual trauma-related PTSD

Cited by 16 publications

References 51 publications

Socioeconomic Deprivation and Dropout from Contemporary Psychological Intervention for Common Mental Disorders: A Systematic Review

Socioeconomic Deprivation and Dropout from Contemporary Psychological Intervention for Common Mental Disorders: A Systematic Review

A Theory of Planned Behavior Scale for Adherence to Trauma‐Focused Posttraumatic Stress Disorder Treatments

Neural changes following equine‐assisted therapy for posttraumatic stress disorder: A longitudinal multimodal imaging study

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