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A randomized clinical trial to assess the efficacy of trial-based cognitive therapy compared to prolonged exposure for post-traumatic stress disorder: preliminary findings

Published online by Cambridge University Press:  26 May 2020

Érica Panzani Duran Open the ORCID record for Érica Panzani Duran [Opens in a new window] ,
Felipe Corchs ,
Andrea Vianna ,
Álvaro Cabral Araújo ,
Natália Del Real ,
Cláudio Silva ,
Ana Paula Ferreira ,
Paula De Vitto Francez ,
Cláudio Godói  and
Helena Silveira
...Show all authors
Érica Panzani Duran*
Affiliation:
Postgraduate Anxiety Program, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil Postgraduate Program of Interactive Processes of Organs and Systems, Health Sciences Institute, Federal University of Bahia, Salvador, Brazil
Felipe Corchs
Affiliation:
Postgraduate Anxiety Program, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Andrea Vianna
Affiliation:
Postgraduate Anxiety Program, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Álvaro Cabral Araújo
Affiliation:
Postgraduate Anxiety Program, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Natália Del Real
Affiliation:
Postgraduate Anxiety Program, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Cláudio Silva
Affiliation:
Postgraduate Anxiety Program, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Ana Paula Ferreira
Affiliation:
Postgraduate Anxiety Program, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Paula De Vitto Francez
Affiliation:
Postgraduate Anxiety Program, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Cláudio Godói
Affiliation:
Postgraduate Anxiety Program, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Helena Silveira
Affiliation:
Postgraduate Anxiety Program, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Lina Matsumoto
Affiliation:
Postgraduate Anxiety Program, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Cristiane Maluhy Gebara
Affiliation:
Postgraduate Anxiety Program, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Tito Paes de Barros Neto
Affiliation:
Postgraduate Anxiety Program, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Raquel Chilvarquer
Affiliation:
Postgraduate Anxiety Program, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Luciana Lima de Siqueira
Affiliation:
Postgraduate Anxiety Program, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Marcio Bernik
Affiliation:
Postgraduate Anxiety Program, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Francisco Lotufo Neto
Affiliation:
Postgraduate Anxiety Program, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
*
*Érica Panzani Duran, Email: [email protected]
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Abstract

Background

Post-traumatic stress disorder (PTSD) is a prevalent mental health condition that is often associated with psychiatric comorbidities and changes in quality of life. Prolonged exposure therapy (PE) is considered the gold standard psychological treatment for PTSD, but treatment resistance and relapse rates are high. Trial-based cognitive therapy (TBCT) is an effective treatment for depression and social anxiety disorder, and its structure seems particularly promising for PTSD. Therefore, we evaluated the efficacy of TBCT compared to PE in patients with PTSD.

Methods

Ninety-five patients (77.6% females) who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria for PTSD were randomly assigned to receive either TBCT (n = 44) or PE (n = 51). Patients were evaluated before and after treatment, and at follow-up 3 months after treatment. The primary outcome was improvement in PTSD symptoms as assessed by the Davidson Trauma Scale (DTS). Secondary outcomes were depression, anxiety, and dysfunctional attitudes assessed by the Beck Depression/Anxiety Inventories and Dysfunctional Attitudes Scale, as well as the dropout rate.

Results

A significant reduction in DTS scores was observed in both arms, but no significant difference between treatments. Regarding the secondary outcomes, we found significant differences in depressive symptoms in favor of TBCT, and the dropout rate was lower in the TBCT group than the PE group.

Conclusion

Our preliminary results suggest that TBCT may be an effective alternative for treating PTSD. Further research is needed to better understand its role and the mechanisms of change in the treatment of this disorder.

Keywords

Post-traumatic stress disorderprolonged exposure therapycognitive behavioral therapytrial-based cognitive therapy.
Type
Original Research
Information
CNS Spectrums , Volume 26 , Issue 4 , August 2021 , pp. 427 - 434
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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