Predictors of treatment noninitiation, dropout, and response for cognitive behavioral therapy for trauma nightmares.

Miller, Katherine E.; Micol, Rachel L.; Davis, Joanne L.; Cranston, Christopher C.; Pruiksma, Kristi E.

doi:10.1037/tra0000389

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…Patients for whom sleep disturbances cause distress and dysfunction may potentially be more motivated to participate in treatment focusing on sleep‐related PTSD symptoms than patients for whom sleep disturbances are experienced less prominently (Miller et al., 2019 ). Furthermore, it has been reported that other factors associated with the multifaceted concept of motivation, for instance illness beliefs, may impact psychotherapy outcome (Reich et al., 2015 ).…”

Section: Discussionmentioning

confidence: 99%

Imagery rehearsal therapy and/or mianserin in treatment of refugees diagnosed with PTSD: Results from a randomized controlled trial

Sandahl

Jennum

Baandrup

et al. 2021

Journal of Sleep Research

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Sleep disturbances are frequently part of the symptomatology in refugees with post‐traumatic stress disorder (PTSD). It has been suggested that targeting sleep disturbances may enhance the outcome of PTSD treatment. However, randomized studies on the effect of treatment focusing on sleep disturbances in refugees with PTSD are lacking. The aim of this study was to examine add‐on treatment with imagery rehearsal therapy (IRT) and/or mianserin against treatment as usual (TAU) alone in a sample of trauma‐affected refugees with PTSD at 8–12 months follow‐up. In a randomized controlled trial, 219 adult refugees diagnosed with PTSD and suffering from sleep disturbances were randomized to four groups (1:1:1:1) receiving, respectively, TAU, TAU + mianserin, TAU + IRT, and TAU + IRT + mianserin. The primary outcome was subjective sleep quality (Pittsburgh Sleep Quality Index) and the secondary outcomes included PTSD and depression symptoms, level of functioning and subjective well‐being. The data were analysed using mixed models. The only significant effect of IRT was on level of functioning (p = .040, ES 0.44), whereas there was no significant effect of mianserin on any of the measured outcomes. Low adherence to both IRT (39%) and mianserin (20%) was observed. Contrary to our hypothesis, we did not find IRT or mianserin to be superior to TAU. The low adherence may potentially cause an underestimation of the effect of IRT and mianserin and indicates a necessity to further analyse the complex factors that may impact the motivation and ability of trauma‐affected refugees to participate in and profit from available treatment options.

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Section: Discussionmentioning

confidence: 99%

Imagery rehearsal therapy and/or mianserin in treatment of refugees diagnosed with PTSD: Results from a randomized controlled trial

Sandahl

Jennum

Baandrup

et al. 2021

Journal of Sleep Research

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“…attended at least one session) then ends treatment before reaching “mutual agreement that therapy has been completed” (Garfield, 1989 ). This excluded studies defining dropout as including patients who did not attend any sessions—consistent with Garfield ( 1989 ) and empirical literature (Kehle-Forbes et al, 2016 ; Kline et al, 2020 ; Miller et al, 2019 ), this review considers those patients as rejecting or failing to initiate treatment, rather than dropping out.…”

Section: Methodsmentioning

confidence: 99%

“…Finally, this review focuses specifically on dropout once treatment has begun, as distinct from treatment non-initiation. In addition to theoretical arguments for this distinction (e.g., Garfield, 1989 ), empirical evidence suggests that factors predicting dropout in-treatment may differ from those predicting non-initiation (Kehle-Forbes et al, 2016 ; Kline et al, 2020 ; Miller et al, 2019 ). Kline et al ( 2020 ) suggest that nuance and specificity are likely to be lost if non-initiation and dropout during treatment are not considered as separate heterogeneous types of discontinuation.…”

Section: Introductionmentioning

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

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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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Sleep in PTSD: treatment approaches and outcomes

Miller

Brownlow

Gehrman

2020

Current Opinion in Psychology

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Predictors of treatment noninitiation, dropout, and response for cognitive behavioral therapy for trauma nightmares.

Abstract: Baseline symptom severity on constructs targeted in treatment are the best indicators of response. Treatment initiation appears to be more significant than dropout. Identifying reasons for treatment noninitiation is needed to maximize engagement. (PsycINFO Database Record

Cited by 3 publications

References 18 publications

Imagery rehearsal therapy and/or mianserin in treatment of refugees diagnosed with PTSD: Results from a randomized controlled trial

Imagery rehearsal therapy and/or mianserin in treatment of refugees diagnosed with PTSD: Results from a randomized controlled trial

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

Sleep in PTSD: treatment approaches and outcomes

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