Psychotherapy Research Today is a free monthly online journal that collates and summarizes the latest research about Psychotherapy, including details on psychiatry, psychoanalysis, methods, outcomes. | ||||||
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Do treatment improvements in PTSD severity affect substance use outcomes? A secondary analysis from a randomized clinical trial in NIDA's Clinical Trials Network.Hien DA, Jiang H, Campbell AN, Hu MC, Miele GM, Cohen LR, Brigham GS, Capstick C, Kulaga A, Robinson J, Suarez-Morales L, Nunes EV City College of New York, North Academic Campus, 160 Convent Ave., New York, NY 10030, USA. dah26@columbia.edu OBJECTIVE: The purpose of the analysis was to examine the temporal course of improvement in symptoms of posttraumatic stress disorder (PTSD) and substance use disorder among women in outpatient substance abuse treatment. METHOD: Participants were 353 women randomly assigned to 12 sessions of either trauma-focused or health education group treatment. PTSD and substance use assessments were conducted during treatment and posttreatment at 1 week and after 3, 6, and 12 months. A continuous Markov model was fit on four defined response categories (nonresponse, substance use response, PTSD response, or global response [improvement in both PTSD and substance use]) to investigate the temporal association between improvement in PTSD and substance use symptom severity during the study's treatment phase. A generalized linear model was applied to test this relationship over the follow-up period. RESULTS: Subjects exhibiting nonresponse, substance use response, or global response tended to maintain original classification; subjects exhibiting PTSD response were significantly more likely to transition to global response over time, indicating maintained PTSD improvement was associated with subsequent substance use improvement. Trauma-focused treatment was significantly more effective than health education in achieving substance use improvement, but only among those who were heavy substance users at baseline and had achieved significant PTSD reductions. CONCLUSIONS: PTSD severity reductions were more likely to be associated with substance use improvement, with minimal evidence of substance use symptom reduction improving PTSD symptoms. Results support the self-medication model of coping with PTSD symptoms and an empirical basis for integrated interventions for improved substance use outcomes in patients with severe symptoms. Published 13 January 2010 in Am J Psychiatry, 167(1): 95-101. Articles on Psychotherapy published 11 January 2010: Social partnered dance for people with serious and persistent mental illness: a pilot study. J Nerv Ment Dis, 198(1): 76-8. Individuals with serious mental illness (SMI) often experience isolation and poor health, but normalized social opportunities aid recovery. This study aimed to determine social dance's feasibility and effects on mood, functional mobility, and balance confidence in 12 people with SMI. Participants danced once per week in 1-hour lessons for 10 weeks. Before and after lessons, participants were evaluated for gait velocity and with one-leg stance, Timed Up and Go, and 6-minute walk tests. ... [Abstract] [Full-text] Evidence for poorer outcome in patients with severe negative trauma-related cognitions receiving prolonged exposure plus cognitive restructuring: implications for treatment matching in posttraumatic stress disorder. J Nerv Ment Dis, 198(1): 72-5. In the current article, we address the existing assumption in the literature on cognitive behavioral treatment of PTSD that patients with severe negative trauma-related cognitions would benefit more from a treatment package that includes exposure and cognitive techniques compared with a treatment that includes exposure only. To test this assumption, 54 PTSD patients were randomized to prolonged exposure therapy or prolonged exposure therapy plus cognitive restructuring. Contrary to ... [Abstract] [Full-text] Patient personality and outcome in short-term psychodynamic psychotherapy. J Nerv Ment Dis, 198(1): 59-66. The current study examines pretherapy patient personality characteristics that may be related to outcome in Short-Term Psychodynamic Psychotherapy. The prognostic ability of the Capacity for Dynamic Process Scale (CDPS; Thackrey et al., A Collection of Psychological Scales. 1993:57-63) was examined in a sample of 71 outpatient adults seeking treatment at a university-based community clinic. The relationship of CDPS to various outcome variables, including both patient and clinician perspectives, ... [Abstract] [Full-text] Articles on Psychotherapy published 5 January 2010: Psychological treatments of binge eating disorder. Arch Gen Psychiatry, 67(1): 94-101. CONTEXT: Interpersonal psychotherapy (IPT) is an effective specialty treatment for binge eating disorder (BED). Behavioral weight loss treatment (BWL) and guided self-help based on cognitive behavior therapy (CBTgsh) have both resulted in short-term reductions in binge eating in obese patients with BED. OBJECTIVE: To test whether patients with BED require specialty therapy beyond BWL and whether IPT is more effective than either BWL or CBTgsh in patients with a high negative affect during a ... [Abstract] [Full-text] Brief, personality-targeted coping skills interventions and survival as a non-drug user over a 2-year period during adolescence. Arch Gen Psychiatry, 67(1): 85-93. CONTEXT: Selective interventions targeting personality risk are showing promise in the prevention of problematic drinking behavior, but their effect on illicit drug use has yet to be evaluated. OBJECTIVE: To investigate the efficacy of targeted coping skills interventions on illicit drug use in adolescents with personality risk factors for substance misuse. DESIGN: Randomized controlled trial. SETTING: Secondary schools in London, United Kingdom. PARTICIPANTS: A total of 5302 students were ... [Abstract] [Full-text] Articles on Psychotherapy published 16 December 2009: Altering cortical connectivity: remediation-induced changes in the white matter of poor readers. Neuron, 64(5): 624-31. Neuroimaging studies using diffusion tensor imaging (DTI) have revealed regions of cerebral white matter with decreased microstructural organization (lowerfractional anisotropy or FA) among poor readers. We examined whether 100 hr of intensive remedial instruction affected the white matter of 8- to 10-year-old poor readers. Prior to instruction, poor readers had significantly lower FA than good readers in a region of the left anterior centrum semiovale. The instruction resulted in a change in ... [Abstract] [Full-text] Articles on Psychotherapy published 9 December 2009: Clinical effectiveness of individual cognitive behavioral therapy for depressed older people in primary care: a randomized controlled trial. Arch Gen Psychiatry, 66(12): 1332-40. CONTEXT: In older people, depressive symptoms are common, psychological adjustment to aging is complex, and associated chronic physical illness limits the use of antidepressants. Despite this, older people are rarely offered psychological interventions, and only 3 randomized controlled trials of individual cognitive behavioral therapy (CBT) in a primary care setting have been published. OBJECTIVE: To determine the clinical effectiveness of CBT delivered in primary care for older people with ... [Abstract] [Full-text] Personality change during depression treatment: a placebo-controlled trial. Arch Gen Psychiatry, 66(12): 1322-30. CONTEXT: High neuroticism is a personality risk factor that reflects much of the genetic vulnerability to major depressive disorder (MDD), and low extraversion may increase risk as well. Both have been linked to the serotonin system. OBJECTIVES: To test whether patients with MDD taking selective serotonin reuptake inhibitors (SSRIs) report greater changes in neuroticism and extraversion than patients receiving inert placebo, and to examine the state effect hypothesis that self-reported ... [Abstract] [Full-text] © 2005-2010 Psychotherapy Research Today. All Rights Reserved. |
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