Effectiveness of interpersonal psychotherapy-trauma for depressed women with childhood abuse histories.

Abstract

Background Women with depression and childhood sexual abuse histories constitute more than 20% of the female patient population in publicly-funded community mental health centers (CMHCs). Interventions are needed that address depression and post-traumatic stress disorder (PTSD) symptoms and social health. Method We compared Interpersonal Psychotherapy-Trauma (IPT-T), an IPT adaptation for this population and setting, to Clinic Psychotherapy (CP). CP clinicians were free to implement the psychotherapy of choice. Women (n=162; 54% White, 10.5% Hispanic; 52.2% Medicaid-insured) with a major depressive episode (MDE) and history of sexual abuse before 18 were randomly assigned to IPT-T or CP. Participants were offered 16 free sessions of IPT-T or CP. Outcomes were MDE remission, improved depression (Beck Depression Inventory, Hamilton Depression Rating Scale) and PTSD symptoms (Modified PTSD Symptom Scale), and improved social health (e.g., UCLA Loneliness Scale). Weighted generalized estimating equations were used to examine outcomes at eight (primary) and 20 (secondary) months post-randomization. Results IPT-T led to greater improvements in PTSD symptoms and many social health indicators, including loneliness and social support, at both eight- and 20-month follow-up. Effect sizes ranged from .18 to .39 at the primary endpoint (eight months). IPT-T and CP yielded comparable improvements in depression symptoms and MDE remission. Conclusion Evidence-based psychotherapies like IPT-T are needed in CMHCs, where some of the most vulnerable patients receive treatment. With comparable findings for depression, IPT-T’s superior improvements in social health and PTSD symptoms are cause for optimism. IPT-T should be evaluated in dissemination trials.

Reducing posttraumatic stress disorder symptom severity among depressed women with childhood sexual abuse histories in interpersonal psychotherapy-trauma: The role of improved social functioning.

“…The current study sought to examine improved social functioning as a potential mediator of the effects of interpersonal psychotherapy-trauma (IPT-T) on PTSD in women with CSA and depression. This was a secondary analysis of data collected in a clinical trial focused on treatment of depression with IPT-T (Duberstein et al., 2018), in which 88% of the sample also met diagnostic criteria for PTSD.…”

“…One possibility is that IPT improves a patient’s security in their interpersonal attachments, which is often threatened after trauma and especially after interpersonal traumas (Markowitz, 2010). IPT also provides social skills to patients and thereby potentiates the likelihood a patient would expose themself to social interactions that may have previously been avoided, even though IPT does not actively encourage exposure (Duberstein et al., 2018; Markowitz et al., 2015). Additionally, improving social functioning may lead to increased social support, shown to be an important factor in successful PTSD recovery (Wampold et al., 2010).…”

“…A recent randomized effectiveness trial (Duberstein et al., 2018) tested IPT-T (Talbot & Gamble, 2008) in a population of women with depression and CSA. IPT-T is an adaptation of traditional IPT tailored to meet the particular needs of a female population with depression and history of CSA in a community mental health center (CMHC; see Method for more details).…”

Internet-based interventions for loneliness : Efficacy and latent psychopathological profiles of treatment seekers

“…While loneliness has been investigated as a secondary outcome in a pair of outcome studies (Duberstein et al, 2018;Johnson et al, 2019), the SOLUS project marks the first time targeting loneliness with the method in a systematic, manualised fashion (to our knowledge). Its hypothesised efficacy was based in the fact that loneliness can arise in relation to interpersonal events (e.g.…”

Building Healthy Children: A preventive intervention for high-risk young families

“…In addition, mothers receiving IPT have shown significant improvement in mother–child relationship quality, perceived stress, parenting attitudes and self-efficacy, and social support (Beeber et al, 2013; Handley, Michl-Petzing, Rogosch, Cicchetti, & Toth, 2017; Mulcahy, Reay, Wilkinson, & Owen, 2010; Toth et al, 2013). Of note, IPT-A and IPT have demonstrated efficacy across racially/ethnically diverse samples from various socioeconomic backgrounds, and in women with histories of trauma and posttraumatic stress disorder (PTSD) (Duberstein et al, 2018; Markowitz et al, 2015; Rossello & Bernal, 1999; Toth et al, 2013).…”