Presence of the dissociative subtype of PTSD does not moderate the outcome of intensive trauma-focused treatment for PTSD. Issue 1 (1st January 2018)

• Record Type: Journal Article
• Authors: Zoet, Harmen A.; Wagenmans, Anouk; van Minnen, Agnes; de Jongh, Ad
• Is Part Of: European journal of psychotraumatology. Volume 9:Issue 1(2018)
• Publication Date: 2018-01-01
• Subjects: Posttraumatic stress disorder -- dissociative subtype of PTSD -- intensive trauma-focused treatment -- prolonged exposure -- EMDR therapy -- stabilization phase -- dissociation; trastorno de estrés postraumático -- subtipo disociativo de TEPT -- tratamiento intensivo centrado en el trauma -- exposición prolongada -- Terapia EMDR -- fase de estabilización -- disociación; 创伤后应激障碍 -- PTSD的分离亚型 -- 以创伤为中心的强化治疗 -- 延长暴露 -- EMDR疗法 -- 稳定阶段 -- 解离; Patients with the dissociative subtype of PTSD (DS) differed from those not having DS in the severity of PTSD levels. -- DS and non-DS patients showed similar levels of improvement after trauma-focused therapy. -- Intensive treatment programmes can be quite effective even for patients with high levels of dissociation.; Post-traumatic stress disorder -- Periodicals; Stress Disorders, Post-Traumatic; Post-traumatic stress disorder; Electronic journals; Periodicals; Periodicals; Fulltext; Internet Resources; Periodicals; 616.8521
• DOI: 10.1080/20008198.2018.1468707
• Languages: English
• ISSNs: 2000-8198

Abstract

ABSTRACT: Background : There is a widely-held belief in the trauma field that the presence of dissociative symptoms is associated with poor treatment response. However, previous research on the effect of dissociation in treatment outcomes pertained to specific patients and trauma populations. Objective : To test the hypothesis that the presence of the dissociative subtype of PTSD (DS) would have a detrimental effect on the outcome of an intensive trauma-focused treatment programme. Methods : PTSD symptom scores (Clinician Administered PTSD Scale [CAPS] and PTSD Symptom Scale Self-Report [PSS-SR]) were analysed using the data of 168 consecutive patients (70.6% female) who had been exposed to a wide variety of multiple traumas, including childhood sexual abuse, and of whom 98.2% were diagnosed with severe PTSD (CAPS > 65). Most of them suffered from multiple comorbidities and 38 (22.6%) met the criteria for DS. They took part in an intensive trauma-focused treatment programme for PTSD. Pre- and post-treatment differences were compared between patients with and without DS. Results : Large effect sizes were achieved for PTSD symptom reduction on CAPS and the PSS-SR, both for patients with DS and those without. Although patients with DS showed a significantly greater PTSD symptom severity at the beginning, and throughout, treatment, both groups showed equal reductions in PTSD symptoms. Of those who met the criteria for DS, 26 (68.4%) no longer fulfilled the criteria for this classification after treatment. Conclusion : The results provide no support for the notion that the presence of DS negatively impacts trauma-focused treatment outcomes. Accordingly, PTSD patients with DS should not be denied effective trauma-focused treatments.