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      Trauma-focused treatment outcome for complex PTSD patients: results of an intensive treatment programme Translated title: Resultado del tratamiento centrado en el trauma para pacientes con TEPT complejo: resultados de un programa de tratamiento intensivo Translated title: 聚焦创伤疗法对于复杂性PTSD患者的治疗结果:强化治疗方案的结果

      research-article
      a , b , a , c , d , e , a , a , b
      European Journal of Psychotraumatology
      Taylor & Francis
      Complex PTSD, post-traumatic stress disorder, intensive trauma-focused treatment, treatment outcome, ITQ, TEPT complejo, Trastorno de estrés postraumático, tratamiento intensivo centrado, en el trauma, resultado del tratamiento, ITQ, 复杂性PTSD, 创伤后应激障碍, 聚焦创伤强化治疗, 治疗结果, ITQ, • The majority, over 85%, of the patients diagnosed with Complex PTSD lost their diagnosis after 8 days of intensive trauma-focused treatment. , • Complex PTSD patients can benefit from trauma-focused treatment and should not be excluded.

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          ABSTRACT

          Background

          Complex PTSD (CPTSD) has been incorporated in the 11th edition of the International Classification of Diseases (ICD-11) as a mental health condition distinct from PTSD.

          Objective

          The objective of the current study is to determine whether individuals classified as having CPTSD can benefit from an intensive trauma-focused treatment, resulting in decreased PTSD and CPTSD symptoms, and loss of diagnoses.

          Method

          Patients diagnosed with PTSD ( N = 308) took part in an intensive 8-day treatment programme combining prolonged exposure, EMDR therapy, psycho-education, and physical activity. The treatment was not phase-based in that it did not contain a stabilization phase or skill training prior to therapy. CPTSD diagnosis was assessed by means of the International Trauma Questionnaire (ITQ) and PTSD diagnosis was assessed with both the ITQ and CAPS-5. Treatment response was measured with the CAPS-5, PCL-5, and ITQ.

          Results

          Symptoms of both PTSD and CPTSD significantly decreased from pre- to post-treatment resulting in a significant loss of CAPS-5 based PTSD (74.0%) and ITQ-based PTSD and CPTSD diagnoses (85.0% and 87.7%, respectively). No adverse events occurred in terms of suicides, suicide attempts, or hospital admissions.

          Conclusions

          The results are supportive of the notion that the majority of patients classified as having CPTSD strongly benefit from an intensive trauma-focused treatment for their PTSD.

           

          Antecedentes: El TEPT complejo (TEPT-C) se ha incorporado en la 11ª edición de la Clasificación Internacional de Enfermedades (CIE-11) como una condición de salud mental distinta del TEPT.

          Objetivo: El objetivo del presente estudio es determinar si las personas clasificadas como con TEPT-C pueden beneficiarse de un tratamiento intensivo centrado en el trauma, lo que resulta en una disminución de los síntomas de TEPT y TEPT-C y la pérdida de diagnóstico de TEPT.

          Método: Los pacientes diagnosticados con TEPT ( N = 308) participaron en un programa de tratamiento intensivo de 8 días que combina exposición prolongada, terapia EMDR, psicoeducación y actividad física. El tratamiento no se dividió en fases, ya que no contenía una fase de estabilización o entrenamiento de habilidades antes de la terapia. El diagnóstico de TEPT-C se evaluó mediante el Cuestionario Internacional de Trauma (ITQ por sus siglas en ingles) y el diagnóstico de TEPT se evaluó tanto con el ITQ como con CAPS-5. La respuesta al tratamiento se midió con CAPS-5, PCL-5 e ITQ.

          Resultados: los síntomas de TEPT y TEPT-C disminuyeron significativamente del pretratamiento al postratamiento, lo que resultó en una pérdida significativa del diagnóstico de TEPT basado en CAPS-5 (74.0%) y diagnósticos de TEPT y TEPT-C basados en ITQ (85.0 y 87.7%, respectivamente). No se produjeron eventos adversos en términos de suicidios, intentos de suicidio o ingresos hospitalarios.

          Conclusiones: Los resultados apoyan la noción de que la mayoría de los pacientes clasificados con TEPT-C se benefician significativamente de un tratamiento intensivo centrado en el trauma para su TEPT.

           

          背景:复杂性PTSD (CPTSD) 已作为不同于PTSD的精神健康疾病, 被纳入《国际疾病分类》第十一次修订版 (ICD-11) 。

          目的:本研究旨在确定被归类为患有CPTSD的个体是否可以从聚焦创伤强化治疗中受益, 从而减轻PTSD和CPTSD症状, 且不再符合诊断。

          方法:308名被诊断患有PTSD的患者参加了一项结合延长暴露疗法, EMDR治疗, 心理教育和体育锻炼的8天强化治疗方案。由于治疗前不含稳定阶段或技能培训, 该治疗不是分阶段的。CPTSD诊断由《国际创伤问卷》 (ITQ) 评估, PTSD诊断使用ITQ和CAPS-5评估。治疗反应使用CAPS-5, PCL-5和ITQ测量。

          结果:从治疗前到治疗后, PTSD和CPTSD症状均显著下降, 导致CAPS-5的PTSD诊断 (74.0%) 以及ITQ的PTSD和CPTSD诊断 (分别为85.0和87.7%) 的显著减少。在自杀, 自杀未遂或住院方面均未发生不良事件。

          结论:本结果支持以下观点, 即大多数被归类为CPTSD的患者都从针对PTSD的聚焦创伤强化治疗中受益匪浅。

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          Most cited references39

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          Diagnostic and Statistical Manual of Mental Disorders

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            The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and Initial Psychometric Evaluation.

            The Posttraumatic Stress Disorder Checklist (PCL) is a widely used DSM-correspondent self-report measure of PTSD symptoms. The PCL was recently revised to reflect DSM-5 changes to the PTSD criteria. In this article, the authors describe the development and initial psychometric evaluation of the PCL for DSM-5 (PCL-5). Psychometric properties of the PCL-5 were examined in 2 studies involving trauma-exposed college students. In Study 1 (N = 278), PCL-5 scores exhibited strong internal consistency (α = .94), test-retest reliability (r = .82), and convergent (rs = .74 to .85) and discriminant (rs = .31 to .60) validity. In addition, confirmatory factor analyses indicated adequate fit with the DSM-5 4-factor model, χ2 (164) = 455.83, p < .001, standardized root mean square residual (SRMR) = .07, root mean squared error of approximation (RMSEA) = .08, comparative fit index (CFI) = .86, and Tucker-Lewis index (TLI) = .84, and superior fit with recently proposed 6-factor, χ2 (164) = 318.37, p < .001, SRMR = .05, RMSEA = .06, CFI = .92, and TLI = .90, and 7-factor, χ2 (164) = 291.32, p < .001, SRMR = .05, RMSEA = .06, CFI = .93, and TLI = .91, models. In Study 2 (N = 558), PCL-5 scores demonstrated similarly strong reliability and validity. Overall, results indicate that the PCL-5 is a psychometrically sound measure of PTSD symptoms. Implications for use of the PCL-5 in a variety of assessment contexts are discussed.
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              The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5): Development and Initial Psychometric Evaluation in Military Veterans.

              The Clinician-Administered PTSD Scale (CAPS) is an extensively validated and widely used structured diagnostic interview for posttraumatic stress disorder (PTSD). The CAPS was recently revised to correspond with PTSD criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). This article describes the development of the CAPS for DSM-5 (CAPS-5) and presents the results of an initial psychometric evaluation of CAPS-5 scores in 2 samples of military veterans (Ns = 165 and 207). CAPS-5 diagnosis demonstrated strong interrater reliability (к = .78 to 1.00, depending on the scoring rule) and test-retest reliability (к = .83), as well as strong correspondence with a diagnosis based on the CAPS for DSM-IV (CAPS-IV; к = .84 when optimally calibrated). CAPS-5 total severity score demonstrated high internal consistency (α = .88) and interrater reliability (ICC = .91) and good test-retest reliability (ICC = .78). It also demonstrated good convergent validity with total severity score on the CAPS-IV (r = .83) and PTSD Checklist for DSM-5 (r = .66) and good discriminant validity with measures of anxiety, depression, somatization, functional impairment, psychopathy, and alcohol abuse (rs = .02 to .54). Overall, these results indicate that the CAPS-5 is a psychometrically sound measure of DSM-5 PTSD diagnosis and symptom severity. Importantly, the CAPS-5 strongly corresponds with the CAPS-IV, which suggests that backward compatibility with the CAPS-IV was maintained and that the CAPS-5 provides continuity in evidence-based assessment of PTSD in the transition from DSM-IV to DSM-5 criteria. (PsycINFO Database Record
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                Author and article information

                Journal
                Eur J Psychotraumatol
                Eur J Psychotraumatol
                European Journal of Psychotraumatology
                Taylor & Francis
                2000-8198
                2000-8066
                23 July 2020
                2020
                : 11
                : 1
                : 1783955
                Affiliations
                [a ]Research Department, PSYTREC; , Bilthoven, The Netherlands
                [b ]Behavioural Science Institute (BSI), Radboud University Nijmegen; , Nijmegen, The Netherlands
                [c ]Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam; , Amsterdam, The Netherlands
                [d ]School of Psychology, Queen’s University; , Belfast, UK
                [e ]Institute of Health and Society, University of Worcester; , Worcester, UK
                Author notes
                CONTACT Eline M. Voorendonk voorendonk@ 123456psytrec.com PSYTREC; , Bilthoven3723 MB, The Netherlands
                Author information
                https://orcid.org/0000-0001-7554-8343
                https://orcid.org/0000-0001-6031-9708
                https://orcid.org/0000-0003-1263-1275
                https://orcid.org/0000-0002-3099-8444
                Article
                1783955
                10.1080/20008198.2020.1783955
                7473266
                33029323
                b8a70113-ea20-4946-98a3-da60c89c57dc
                © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Figures: 4, Tables: 2, References: 45, Pages: 1
                Categories
                Research Article
                Clinical Research Article

                Clinical Psychology & Psychiatry
                complex ptsd,post-traumatic stress disorder,intensive trauma-focused treatment,treatment outcome,itq,tept complejo,trastorno de estrés postraumático,tratamiento intensivo centrado,en el trauma,resultado del tratamiento,复杂性ptsd,创伤后应激障碍,聚焦创伤强化治疗,治疗结果,• the majority, over 85%, of the patients diagnosed with complex ptsd lost their diagnosis after 8 days of intensive trauma-focused treatment.,• complex ptsd patients can benefit from trauma-focused treatment and should not be excluded.

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