In rape trauma PTSD, patient characteristics indicate which trauma‐focused treatment they are most likely to complete

Keefe John R.; Wiltsey Stirman Shannon; Cohen Zachary D.; DeRubeis Robert J.; Smith Brian N.; Resick Patricia A.

摘要

Background >Dropout rates for effective therapies for posttraumatic stress disorder (PTSD) can be high, especially in practice settings. Although clinicians have intuitions regarding what treatment patients may complete, there are few systematic data to drive those judgments. </section> <section xml:id="da22731-sec-0020"> <title type="main">Methods > A multivariable model of dropout risk was constructed with randomized clinical trial data ( n ?=?160) comparing prolonged exposure (PE) and cognitive processing therapy (CPT) for rape‐induced PTSD. A two‐step bootstrapped variable selection algorithm was applied to identify moderators of dropout as a function of treatment condition. Employing identified moderators in a model, fivefold cross‐validation yielded estimates of dropout probability for each patient in each condition. Dropout rates between patients who did and did not receive their model‐indicated treatment were compared. </section> <section xml:id="da22731-sec-0030"> <title type="main">Results >Despite equivalent dropout rates across treatments, patients assigned to their model‐indicated treatment were significantly less likely to drop out relative to patients who did not (relative risk?=?0.49 [95% CI: 0.29–0.82]). Moderators included in the model were: childhood physical abuse, current relationship conflict, anger, and being a racial minority, all of which were associated with higher likelihood of dropout in PE than CPT. </section> <section xml:id="da22731-sec-0040"> <title type="main">Conclusions >Individual differences among patients affect the likelihood they will complete a particular treatment, and clinicians can consider these moderators </span> <span class="z_kbtn z_kbtnclass hoverxs" style="display: none;">展开▼</span> </div> <div class="translation abstracttxt"> <span class="zhankaihshouqi fivelineshidden" id="abstract"> <span>机译：</span><Abstract Type =“Main”XML：Lang =“En”> <第XML：ID =“DA22731-SEC-0010”> <标题类型=“main”>背景</ title> >有效疗法的辍学率对于前后应激障碍（PTSD）可以很高，特别是在实践环境中。虽然临床医生对治疗患者的直觉可能完成，但有很少的系统数据来推动这些判断。</ p> </段> <部分XML：ID =“da22731-ex-0020”> <标题类型=“main”方法</ title> >将多变量辍学风险模型构建，随机临床试验数据（ n </ i>？=α160），比较长期暴露（PE）和认知处理治疗（CPT）强奸诱导的前肢。应用了两步的引导变量选择算法，以识别作为治疗条件的函数的丢失主持人。在模型中使用所识别的主持人，五倍交叉验证在每个条件下产生对每位患者的辍学概率估计。比较了患者之间的辍学率，并没有得到其表明治疗的患者。 </ p> </ section> <section XML：ID =“DA22731-SEC-0030”> <标题类型=“MAIN”>结果</标题> <P>尽管治疗中的等效辍学率，分配给他们的模型 - 相对于没有（相对风险的患者，indicated治疗显着不太可能脱落（相对风险？= 0.49 [95％CI：0.29-0.82]）。模型中包含的主持人是：童年身体虐待，当前关系冲突，愤怒和作为种族少数群体，所有这些都与PE的辍学可能性高于CPT相关。</ p> </ section> <section XML： ID =“da22731-sec-0040”> <标题类型=“main”>结论</ title> >患者之间的个体差异影响它们将完成特定治疗的可能性，临床医生可以考虑这些主持人 </span> <span class="z_kbtn z_kbtnclass hoverxs" style="display: none;">展开▼</span> </div> </div> <div class="record"> <h2 class="all_title" id="enpatent33" > 著录项</h2> <ul> <li> <span class="lefttit">来源</span> <div style="width: 86%;vertical-align: text-top;display: inline-block;"> <a href='/journal-foreign-32884/'>《Depression and anxiety 》</a> <b style="margin: 0 2px;">|</b><span>2018年第4期</span><b style="margin: 0 2px;">|</b> <span>共9页</span> </div> </li> <li> <div class="author"> <span class="lefttit">作者</span> <p id="fAuthorthree" class="threelineshidden zhankaihshouqi"> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Keefe John R.&option=202" target="_blank" rel="nofollow">Keefe John R.;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Wiltsey Stirman Shannon&option=202" target="_blank" rel="nofollow">Wiltsey Stirman Shannon;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Cohen Zachary D.&option=202" target="_blank" rel="nofollow">Cohen Zachary D.;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=DeRubeis Robert J.&option=202" target="_blank" rel="nofollow">DeRubeis Robert J.;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Smith Brian N.&option=202" target="_blank" rel="nofollow">Smith Brian N.;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Resick Patricia A.&option=202" target="_blank" rel="nofollow">Resick Patricia A.;</a> </p> <span class="z_kbtnclass z_kbtnclassall hoverxs" id="zkzz" style="display: none;">展开▼</span> </div> </li> <li> <div style="display: flex;"> <span class="lefttit">作者单位</span> <div style="position: relative;margin-left: 3px;max-width: 639px;"> <div class="threelineshidden zhankaihshouqi" id="fOrgthree"> <p>Department of PsychologyUniversity of PennsylvaniaPhiladelphia PA USA;</p> <p>Psychiatry and Behavioral SciencesPalo Alto Veterans Affairs Health SystemPalo Alto CA USA;</p> <p>University of PennsylvaniaPhiladelphia PA USA;</p> <p>Department of PsychologyUniversity of PennsylvaniaPhiladelphia PA USA;</p> <p>National Center for PTSDVA Boston Healthcare SystemBoston MA USA;</p> <p>Duke UniversityDurham NC USA;</p> </div> <span class="z_kbtnclass z_kbtnclassall hoverxs" id="zhdw" style="display: none;">展开▼</span> </div> </div> </li> <li> <span class="lefttit">收录信息</span> <span style="width: 86%;vertical-align: text-top;display: inline-block;"></span> </li> <li> <span class="lefttit">原文格式</span> <span>PDF</span> </li> <li> <span class="lefttit">正文语种</span> <span>eng</span> </li> <li> <span class="lefttit">中图分类</span> <span>R749.72; </span> </li> <li class="antistop"> <span class="lefttit">关键词</span> <p style="width: 86%;vertical-align: text-top;"> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=behavior therapy&option=203" rel="nofollow">behavior therapy;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=CBT/cognitive behavior therapy&option=203" rel="nofollow">CBT/cognitive behavior therapy;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=clinical trials&option=203" rel="nofollow">clinical trials;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=empirical supported treatments&option=203" rel="nofollow">empirical supported treatments;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=PTSD/posttraumatic stress disorder&option=203" rel="nofollow">PTSD/posttraumatic stress disorder;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=trauma&option=203" rel="nofollow">trauma;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=treatment&option=203" rel="nofollow">treatment;</a> </p> <div class="translation"> 机译：行为治疗;CBT /认知行为治疗;临床试验;经验支持的治疗;PTSD / PRERTRAUMATIC胁迫障碍;创伤;治疗; 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href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=赵晓东&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor"> . 赵晓东</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=刘红升&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">,刘红升</a> <span> <a href="/journal-cn-12963/" target="_blank" rel="nofollow" class="tuijian_authcolor"> . 临床误诊误治 </a> </span> <span> . 2015</span><span> ,第004期</span> </span> </div> </li> <li> <div> <b>6. </b><a class="enjiyixqcontent" href="/academic-conference-cn_meeting-7066_thesis/020221844113.html">中美危重创伤患者的死亡风险特征:基于三个一级创伤中心的计算机模式识别研究</a> <b>[C]</b> <span> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=江华&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor"> . 江华</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Burruss Sigrid&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">,Burruss Sigrid</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Britt Redick&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">,Britt Redick</a> <span> <a href="/conference-cn-7066/" target="_blank" rel="nofollow" class="tuijian_authcolor"> . 中华医学会急诊医学分会第十五次全国急诊医学学术年会 </a> <span> <span> . 2012</span> </span> </div> </li> <li> <div> <b>7. </b><a class="enjiyixqcontent" href="/academic-degree-domestic_mphd_thesis/020315555811.html">创伤后康复期患者应激障碍、创伤后成长特点与影响因素及rTMS治疗的研究</a> <b>[A] </b> <span> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=王艺&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor"> . 王艺</a> <span> . 2014</span> </span> </div> </li> </ul> <ul style="display: none;"> <li> <div> <b>1. </b><a class="enjiyixqcontent" href="/patent-detail/06120103739081.html">使用胶质细胞原纤维酸性蛋白(GFAP)和/或泛素羧基末端水解酶L1(UCH-L1)帮助诊断和评价已遭受骨科损伤并已遭受或可能已遭受头部损伤诸如轻度创伤性脑损伤(TBI)的患者的方法</a> <b>[P]</b> . <span> 中国专利： CN111094983A </span> <span> . 2020-05-01</span> </div> </li> <li> <div> <b>2. </b><a class="enjiyixqcontent" href="/patent-detail/06120105218593.html">治疗糖尿病患者创伤、烧烫伤、溃疡、褥疮的药物及制法</a> <b>[P]</b> . <span> 中国专利： CN101020000A </span> <span> . 2007-08-22</span> </div> </li> <li> <div> <b>3. </b><a class="enjiyixqcontent" href="/patent-detail/06130432833056.html">compound, pharmaceutical composition, method of selective activation/stimulation of nicotinic receptors from to-7 in a patient in which such activation/stimulation has a therapeutic effect, method of treating a patient suffering from a psychotic disease, a neurodegenerative disease involving a dysfunction of the cholinergic system, and/or a condition of impaired memory and/or cognition, method of treatment of a patient suffering from dementia and/or another condition with memory loss, method of treatment of a patient suffering from memory impairment due to mild cognitive impairment due to aging, alzheimer's malady,schizophrenia, parkinson malady, huntington malady, pick malady, creutzfeldt-jakob malady, depression, aging, head trauma, stroke, snc hypoxia, cerebral senility, multiinfarction dementia, HIV and/or cardiovascular disease, method of treatment and/or prevention of dementia in a patient with alzheimer's disease, method of treating a patient to cut off the alcohol vein or treat</a> <b>[P]</b> . <span> 外国专利：  BRPI0517494A </span> <span> . 2008-10-14</span> </div> <p class="zwjiyix translation" style="max-width: initial;height: auto;word-break: break-all;white-space: initial;text-overflow: initial;overflow: initial;"> <span>机译：化合物，药物组合物，在其中这种激活/刺激具有治疗作用的患者中选择性激活/刺激烟碱受体从to-7的方法，治疗患有精神病，涉及神经功能障碍的神经退行性疾病的患者的方法胆碱能系统和/或记忆力和/或认知障碍的状况，患有痴呆症的患者的治疗方法和/或患有记忆力丧失的另一种状况，由于轻度认知障碍而遭受记忆力障碍的患者的治疗方法由于衰老，阿尔茨海默氏病，精神分裂症，帕金森氏病，亨廷顿氏病，匹克病，creutzfeldt-jakob病，抑郁症，衰老，头部外伤，中风，snc缺氧，脑衰老，多发性梗塞性痴呆，HIV和/或心血管疾病，治疗方法治疗和/或预防老年痴呆症患者的痴呆症，治疗患者的方法以切断酒精静脉或治疗 </span> </p> </li> <li> <div> <b>4. </b><a class="enjiyixqcontent" href="/patent-detail/06130414047791.html">DEVICE FOR THE TREATMENT OF PATIENTS WITH trauma and the effects of trauma proximal femur</a> <b>[P]</b> . <span> 外国专利：  RU2013127374A </span> <span> . 2014-12-20</span> </div> <p class="zwjiyix translation" style="max-width: initial;height: auto;word-break: break-all;white-space: initial;text-overflow: initial;overflow: initial;"> <span>机译：治疗创伤患者的装置以及股骨近端的创伤作用 </span> </p> </li> <li> <div> <b>5. </b><a class="enjiyixqcontent" href="/patent-detail/06130421832662.html">DEVICE FOR THE TREATMENT OF PATIENTS WITH trauma and the effects of trauma proximal femur</a> <b>[P]</b> . <span> 外国专利：  RU120354U1 </span> <span> . 2012-09-20</span> </div> <p class="zwjiyix translation" style="max-width: initial;height: auto;word-break: break-all;white-space: initial;text-overflow: initial;overflow: initial;"> <span>机译：治疗创伤患者的装置以及股骨近端的创伤作用 </span> </p> </li> </ul> </div> </div> </div> <div class="theme cardcommon" style="overflow: auto;display:none"> <h3 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