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      Developmentally adapted cognitive processing therapy for adolescents and young adults with PTSD symptoms after physical and sexual abuse: study protocol for a randomized controlled trial

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          Abstract

          Background

          Although childhood sexual and/or physical abuse (CSA/CPA) is known to have severe psychopathological consequences, there is little evidence on psychotherapeutic interventions for adolescents and young adults suffering from post-traumatic stress disorder (PTSD). Equally sparse are data on moderators of treatment response on PTSD-related epigenetic changes, health care costs and loss of productivity, alterations in cognitive processing, and on how successful interventions affect all of these factors. Early treatment may prevent later (co)morbidity. In this paper, we present a study protocol for the evaluation of a newly developed psychotherapeutic manual for PTSD after CSA/CPA in adolescents and young adults – the Developmentally Adapted Cognitive Processing Therapy (D-CPT).

          Methods/design

          In a multicenter randomized controlled trial (RCT) D-CPT is compared to treatment as usual (TAU). A sample of 90 adolescent outpatients aged 14 to 21 years will be randomized to one of these conditions. Four assessments will be carried out at baseline, at end of treatment, and 3 and 6 months after end of therapy. Each time, patients will be assessed via clinical interviews and a wide range of questionnaires. In addition to PTSD symptoms and comorbidities, we will evaluate moderators of treatment response, epigenetic profiles, direct and indirect costs of this disorder, and neurophysiological processing of threat cues in PTSD and their respective changes in the course of these two treatments (D-CPT and TAU).

          Discussion

          The study will provide new insights in the understudied field of PTSD in adolescents and young adults. A newly developed intervention will be evaluated in this therapeutically underserved population. Results will provide data on treatment efficacy, direct and indirect treatment costs, as well as on associations of treatment outcome and PTSD intensity both to epigenetic profiles and to the neurobiological processing of threat cues. Besides, they will help to learn more about the psychopathology and possible new objective correlates of PTSD.

          Trial registration

          Germanctr.de identifier: DRKS00004787.

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          Most cited references34

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          CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials.

          Kenneth F Schulz, Douglas G. Altman, David Moher (2010)
          The CONSORT (Consolidated Standards of Reporting Trials) statement is used worldwide to improve the reporting of randomized, controlled trials. Schulz and colleagues describe the latest version, CONSORT 2010, which updates the reporting guideline based on new methodological evidence and accumulating experience.
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            Violence, abuse, and crime exposure in a national sample of children and youth.

            Heather Turner, David Finkelhor, Richard Ormrod … (2009)
            The objective of this research was to obtain national estimates of exposure to the full spectrum of the childhood violence, abuse, and crime victimizations relevant to both clinical practice and public-policy approaches to the problem. The study was based on a cross-sectional national telephone survey that involved a target sample of 4549 children aged 0 to 17 years. A clear majority (60.6%) of the children and youth in this nationally representative sample had experienced at least 1 direct or witnessed victimization in the previous year. Almost half (46.3%) had experienced a physical assault in the study year, 1 in 4 (24.6%) had experienced a property offense, 1 in 10 (10.2%) had experienced a form of child maltreatment, 6.1% had experienced a sexual victimization, and more than 1 in 4 (25.3%) had been a witness to violence or experienced another form of indirect victimization in the year, including 9.8% who had witnessed an intrafamily assault. One in 10 (10.2%) had experienced a victimization-related injury. More than one third (38.7%) had been exposed to 2 or more direct victimizations, 10.9% had 5 or more, and 2.4% had 10 or more during the study year. The scope and diversity of child exposure to victimization is not well recognized. Clinicians and researchers need to inquire about a larger spectrum of victimization types to identify multiply victimized children and tailor prevention and interventions to the full range of threats that children face.
            Article 0 comments Cited 170 times – based on 0 reviews     Review now
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              The short version of the Borderline Symptom List (BSL-23): development and initial data on psychometric properties.

              Alexandra Philipsen, Erika L Chapman, Melanie Domsalla … (2008)
              The full version of the Borderline Symptom List (BSL; for clarification now labeled BSL-95) is a self-rating instrument for specific assessment of borderline-typical symptomatology. The BSL-95 items are based on criteria of the DSM-IV, the revised version of the Diagnostic Interview for Borderline Personality Disorder, and the opinions of both clinical experts and borderline patients. The BSL-95 includes 95 items. In order to reduce patient burden and assessment time, a short version with 23 items (BSL-23) was developed. The development of the BSL-23 was based on a sample of 379 borderline patients, considering the items from the BSL-95 that had the highest levels of sensitivity to change and the highest ability to discriminate borderline patients from other patient groups. In a second step, the psychometric properties of the BSL-23 were investigated and compared with the psychometric properties of the BSL-95 in 5 different samples, including a total of 659 borderline patients. In all of the samples, a high correlation of the sum score was found between the BSL-23 and the BSL-95 (range: 0.958-0.963). The internal consistency was high for both versions (BSL-23/Cronbach's alpha: 0.935-0.969; BSL-95/Cronbach's alpha: 0.977-0.978). Both BSL-23 and BSL-95 clearly discriminated borderline personality disorder patients from patients with an axis I diagnosis (mean effect sizes were 1.13 and 0.96 for the BSL-23 and BSL-95, respectively). In addition, comparisons before and after 3 months of dialectical behavior therapy revealed a numerically larger effect size for the BSL-23 (d = 0.47) compared to the BSL-95 (d = 0.38). The results indicate that the BSL-23 is an efficient and convenient self-rating instrument that displays good psychometric properties comparable to those of the BSL-95. The BSL-23 also demonstrated sensitivity to the effects of therapy. (c) 2008 S. Karger AG, Basel.
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                Author and article information

                Contributors
                Rita Rosner
                Hans-Helmut König
                Frank Neuner
                Ulrike Schmidt
                Regina Steil
                Journal
                Journal ID (nlm-ta): Trials
                Journal ID (iso-abbrev): Trials
                Title: Trials
                Publisher: BioMed Central
                ISSN (Electronic): 1745-6215
                Publication date Collection: 2014
                Publication date (Electronic): 29 May 2014
                Volume: 15
                Page: 195
                Affiliations
                [1 ]Department of Clinical and Biological Psychology, Catholic University Eichstätt-Ingolstadt, Ostenstr. 25, Eichstätt 85071, Germany
                [2 ]Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany
                [3 ]Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld 33501, Germany
                [4 ]Max-Planck-Institute of Psychiatry, Kraepelinstr. 2-10, Munich 80804, Germany
                [5 ]Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Varrentrappstr. 40-42, Frankfurt am Main 60054, Germany
                Article
                Publisher ID: 1745-6215-15-195
                DOI: 10.1186/1745-6215-15-195
                PMC ID: 4055428
                PubMed ID: 24886027
                SO-VID: 31b88970-f482-469c-814e-58f83560fd15
                Copyright © Copyright © 2014 Rosner et al.; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 7 February 2014
                Date accepted : 6 May 2014
                Categories
                Subject: Study Protocol

                ScienceOpen disciplines: Medicine
                Keywords: abuse,adolescents,cognitive processing therapy,post-traumatic stress disorder
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: abuse, adolescents, cognitive processing therapy, post-traumatic stress disorder

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