Predictors and Outcomes of Sudden Gains and Sudden Regressions in Cognitive Behavioral Therapy for Youth Anxiety

Durland, Phoebe H.; Wyszynski, Christopher M.; Chu, Brian C.

doi:10.1016/j.beth.2018.01.006

Cited by 5 publications

(3 citation statements)

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“…A criticism that has been raised is that SGs contribute to overall improvement, and thus those with SGs are statistically more likely to demonstrate better outcome (Stiles et al, 2003). Using the same instrument may also create a shared method bias (Durland et al, 2018). To correct for this problem, some studies have used a different primary outcome measure than the instrument used to capture SGs while measuring the same types of symptoms for both (e.g., Stiles et al, 2003).…”

Section: Lists Of Tablesmentioning

confidence: 99%

“…To correct for this problem, some studies have used a different primary outcome measure than the instrument used to capture SGs while measuring the same types of symptoms for both (e.g., Stiles et al, 2003). Other researchers have defined their outcome as diagnostic remission rather than using the total score on a measure (e.g., Durland et al, 2018), or have used a functional outcome measure rather than symptom outcome measure to tap into a different construct (e.g., Durland et al, 2018). Interestingly, in Shalom and Aderka's (2020) metaanalysis, studies that used a different outcome instrument from the instrument used to identify SGs to measure the same construct reported similar effect sizes for outcomes between those with and without SGs, compared to studies that used identical measures for both.…”

Section: Lists Of Tablesmentioning

confidence: 99%

“…Given that the OQ-SR is serving as a predictor and outcome, this would make these variables more statistically related to one another which may explain why this finding is significant but was not significant when OQ-IR and PTSD SGs are predictors. This relates to the problem of shared method variance in the literature, where often the same instrument used to measure SGs is also used to assess outcome which can lead to an inflated correlation between the two (Durland et al, 2018;Stiles et al, 2003). However, another possibility is that in order to improve social role functioning, SGs in social role functioning are needed and that PTSD and OQ-IR SGs may be irrelevant.…”

Section: Aimmentioning

confidence: 99%

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Sudden Gains in PTSD Symptoms and Social Functioning in Cognitive Processing Therapy for Post traumatic Stress Disorder

Sijercic

2024

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Sudden gains (SGs) are rapid improvements in symptoms between two consecutive therapy sessions, and have been shown to relate to treatment outcomes. This dissertation investigated SGs in Posttraumatic Stress Disorder (PTSD) symptoms, interpersonal relationship functioning, and social role functioning, in a Cognitive Processing Therapy (CPT) implementation effectiveness trial. This was the first study to the author's knowledge to investigate SGs beyond primary symptoms in CPT. The three forms of SGs were examined to better understand their timing, frequency, overlap, and how they each predict outcomes over time. The results indicated that PTSD SGs occurred more often and at different sessions than SGs in facets of social functioning. Most individuals experienced only one form of SG and there were no significant clinical or demographic differences in those who had PTSD only SGs, social functioning only SGs, or both symptom and functioning SGs. PTSD SGs and interpersonal relationship functioning SGs both predicted changes in PTSD symptoms and interpersonal difficulties over time, but not changes in social role functioning. SGs in social role functioning predicted all three forms of outcomes. The findings suggested that there are multiple forms of SGs beyond primary symptom changes that CPT aims to target, and these various SGs are all predictive of patient outcomes. Clinicians should highlight various SGs that patients may experience to further enhance outcomes. Additional research is needed to better understand the cause of different forms of SGs, additional forms of SGs beyond those measured in the present study, and the most appropriate ways to define SGs or comparison groups.

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Section: Lists Of Tablesmentioning

confidence: 99%