Present-centered therapy (PCT) for post-traumatic stress disorder (PTSD) in adults

Belsher, Bradley E.; Beech, Erin H.; Evatt, Daniel P.; Rosen, Craig S.; Xian, Liu; Otto, Jean; Schnurr, Paula P.

doi:10.1002/14651858.cd012898.pub2

Cited by 48 publications

(43 citation statements)

References 71 publications

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“…In an older meta-analysis based on five RCTs, PCT showed good results in PTSD treatment and lower dropout rates than trauma-focused approaches (26). In a recent Cochrane review (27) based on 12 RCTs, PCT was found to be superior to waitlist (SMD = −0.84). A comparison of PCT to trauma-focused CBT did not support PCT non-inferiority.…”

Section: Introductionmentioning

confidence: 98%

Feasibility of Present-Centered Therapy for Prolonged Grief Disorder: Results of a Pilot Study

et al. 2021

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Present-centered therapy (PCT) was originally developed as a strong comparator for the non-specific effects of psychotherapy in the treatment of posttraumatic stress disorder. PCT qualifies as a not strictly supportive treatment as it is structured and homework is assigned between sessions. It does not focus on cognitive restructuring or exposure. A growing body of literature supports its beneficial effects. For example, it demonstrated only slightly inferior effect sizes and lower dropout rates compared to that of trauma-focused cognitive behavioral therapy in several trials with patients suffering from posttraumatic stress disorder. The current study is the first to evaluate the feasibility and the treatment effects of PCT in adults with prolonged grief disorder (PGD). Meta-analyses on psychotherapy for PGD have yielded moderate effect sizes. N = 20 individuals suffering from PGD were treated with PCT by novice therapists as part of a preparation phase for an upcoming RCT in an outpatient setting. Treatment consisted of 20–24 sessions á 50 min. All outcomes were assessed before treatment, at post-treatment, and at the 3-month follow-up. The primary outcome, PGD symptom severity, was assessed using the Interview for Prolonged Grief-13. Secondary outcomes were self-reported PGD severity, depression, general psychological distress, and somatic symptom severity. Furthermore, therapists evaluated their experiences with their first PCT patient and the treatment manual. In intent-to-treat analyses of all patients we found a significant decrease in interview-based PGD symptom severity at post-treatment (d = 1.26). Decreases were maintained up to the 3-month follow-up assessment (d = 1.25). There were also significant decreases in self-reported PGD symptoms, depression, and general psychological distress. No changes were observed for somatic symptoms. The completion rate was 85%. Therapists deemed PCT to be a learnable treatment program that can be adapted to the patient's individual needs. The preliminary results of PCT as a treatment for PGD demonstrate large effects and indicate good feasibility in outpatient settings. The treatment effects were larger than those reported in meta-analyses. Thus, PCT is a promising treatment for PGD. Possible future research directions are discussed.

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Section: Introductionmentioning

confidence: 98%

Feasibility of Present-Centered Therapy for Prolonged Grief Disorder: Results of a Pilot Study

et al. 2021

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“…Even if the drug treatment is effective, but according to the standard, the moderate effect size is an SMD range of 0.5–0.8, so the drugs effect is very small ( Cohen, 2013 ), and no drugs show statistically significant high efficacy. Therefore, compared with psychotherapy ( Belsher et al, 2019 ; Rasmussen et al, 2019 ), drug therapy is more suitable as an adjuvant therapy. It is hoped that future studies can further confirm the results of this study and analyze the differences among different groups in more detail.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, drug treatment is possible. American Psychological Association (APA) and National Institute for Health and Care Excellence (NICE) guidelines ( Wynn, 2015 ; Association, 2017 ) and some studies have indicated that psychotherapy is effective ( Gerger et al, 2014 ; Belsher et al, 2019 ), but the effect of drug treatment is not satisfactory. The Food and Drug Administration (FDA) of the United States currently only approves sertraline and paroxetine for the treatment of PTSD, while APA guidelines recommend fluoxetine, paroxetine, sertraline and venlafaxine ( Association, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Key Clinical Interest Outcomes of Pharmaceutical Administration for Veterans With Post-Traumatic Stress Disorder Based on Pooled Evidences of 36 Randomised Controlled Trials With 2,331 Adults

et al. 2020

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Background: The effects of drug treatment on veterans, who have a high risk of post-traumatic stress disorder (PTSD), are not clear, and the guidelines are different from the recommendations of the recent meta-analysis. Our goal was to find the efficacy and frequencies of complications of drugs that can treat PTSD in veterans.Method: We searched Ovid MEDLINE, Ovid Embase, The Cochrane Library and Web of Science until January 1, 2020. The outcomes were designed as the change of PTSD total scale, subsymptom score, response rate, frequencies of complications outcomes, and acceptability.Results: We included a total of 36 randomised controlled trials with a total of 2,331 adults. In terms of overall effect, drug treatment is more effective than placebo in change in total PTSD symptoms scale (SMD = −0.24, 95% CI [−0.42, −0.06]) and response (RR = 1.66, 95% CI [1.01, 2.72]). However, in terms of frequencies of complications, drugs generally had a higher withdrawal rate (RR = 1.02, 95% CI [0.86, 1.20]) and a higher frequencies of complications (RR = 1.72, 95% CI [1.20, 2.47]) than placebo. Risperidone showed a good curative effect in change in total PTSD symptoms scale (SMD = −0.22, 95% CI [−0.43, 0.00]) and acceptability (RR = 1.31, 95% CI [0.82, 2.59]). The drugs acting on 5−HT receptors, our results showed that symptoms of hyper−arousal (SMD = −0.54, 95% CI [−0.86, −0.21]), symptoms of re−experiencing (SMD = −0.62, 95% CI [−0.86, −0.39]) and symptoms of avoidance (SMD = −0.53, 95% CI [− 0.77,−0.3]), The drugs acting on dopamine receptors, our results showed that symptoms of re−experiencing (SMD = −0.35, 95% CI [−0.55, −0.16]) and the drugs acting on α2 receptor has a significant effect on reducing total PTSD symptoms scale (SMD = −0.34, 95% CI [−0.62, −0.06]).Conclusion: Drug therapy can effectively treat PTSD, but its frequencies of complications should be considered. Different from the guidelines for adult PTSD, this study supports atypical antipsychotics, selective serotonin reuptake inhibitors and receptors that act on 5-HT and dopamine for the treatment of PTSD in veterans. Based on evidence among these drugs, the risperidone is the most effective for veterans, otherwise, sertraline is used as an alternative.

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“…Even if the drug treatment is effective, but according to the standard, the moderate effect size is an SMD range of 0.5-0.8, so the drugs effect is very small (Cohen, 2013), and no drugs show statistically significant high efficacy. Therefore, compared with psychotherapy (Belsher et al, 2019;Rasmussen et al, 2019), drug therapy is more suitable as an adjuvant therapy. It is hoped that future studies can further confirm the results of this study and analyze the differences among different groups in more detail.…”

Section: Implications For Practicementioning

confidence: 99%

“…Therefore, drug treatment is possible. American Psychological Association (APA) and National Institute for Health and Care Excellence (NICE) guidelines (Wynn, 2015;Association, 2017) and some studies have indicated that psychotherapy is effective (Gerger et al, 2014;Belsher et al, 2019), but the effect of drug treatment is not satisfactory. The Food and Drug Administration (FDA) of the United States currently only approves sertraline and paroxetine for the treatment of PTSD, while APA guidelines recommend fluoxetine, paroxetine, sertraline and venlafaxine (Association, 2017).…”

Section: Introductionmentioning

confidence: 99%

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Present-centered therapy (PCT) for post-traumatic stress disorder (PTSD) in adults

Cited by 48 publications

References 71 publications

Feasibility of Present-Centered Therapy for Prolonged Grief Disorder: Results of a Pilot Study

Feasibility of Present-Centered Therapy for Prolonged Grief Disorder: Results of a Pilot Study

Key Clinical Interest Outcomes of Pharmaceutical Administration for Veterans With Post-Traumatic Stress Disorder Based on Pooled Evidences of 36 Randomised Controlled Trials With 2,331 Adults

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