Brief Treatment of Symptoms of Post-Traumatic Stress Disorder (PTSD) by Use of Accelerated Resolution Therapy (ART®)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participant Inclusion and Exclusion
2.2. Recruitment
2.3. Therapist Training
2.4. Participant Intake Assessment
2.5. ART Protocol
2.6. Individual ART Sessions
2.7. Data Collection
2.8. Statistical Methods
3. Results
3.1. Screening and Enrollment
3.2. Demographic and Presenting Characteristics
Characteristic | All (n = 80) | Male (n = 18) | Female (n = 62) | |
---|---|---|---|---|
Age in years (mean ± SD) | 40.0 ± 10.2 | 41.9 ± 11.8 | 40.6 ± 9.8 | |
Race (%) | ||||
Black or African American | 7.5 | 0.0 | 9.7 | |
White | 88.8 | 94.4 | 87.1 | |
Asian | 1.3 | 0.0 | 1.6 | |
Native Hawaiian/Pacific Islander | 0.0 | 0.0 | 0.0 | |
American Indian/Alaskan Native | 1.3 | 0.0 | 1.6 | |
Not reported | 1.2 | 5.6 | 0.0 | |
Hispanic (%) | 28.6 | 5.6 | 35.6 | |
Married (%) | 58.8 | 61.1 | 58.1 | |
Employed – full or part time (%) | 59.8 | 72.2 | 55.9 | |
PDSQ score (mean ± SD) (T-score) | 53.7 ± 8.6 | 54.6 ± 8.6 | 53.5 ± 8.6 | |
Less than 40 (%) | 2.5 | 0.0 | 3.2 | |
40 to 60 (%) | 75.0 | 77.8 | 74.2 | |
More than 60 (%) | 22.5 | 22.2 | 22.6 | |
PCL-C score (mean ± SD) | 54.5 ± 13.0 | 57.3 ± 14.3 | 53.7 ± 12.6 | |
Less than 40 (%) | 13.8 | 11.1 | 14.5 | |
40 to 60 (%) | 47.5 | 38.9 | 50.0 | |
More than 60 (%) | 38.8 | 50.0 | 35.5 | |
No. of traumatic memories still impacting life (%) | ||||
1 to 2 | 19.0 | 23.57 | 17.7 | |
3 to 4 | 31.6 | 35.3 | 30.6 | |
5 or more | 49.4 | 41.2 | 51.6 | |
Previous treatment for PTSD/other MH condition (%) | 67.9 | 50.0 | 73.3 | |
On disability for PTSD or other MH disorder (%) | 10.1 | 5.9 | 11.3 | |
Guilt associated with traumatic memory(ies) (%) | 81.3 | 88.9 | 79.0 | |
Time lived with traumatic memory(ies) (%) | ||||
Less than 1 year | 6.3 | 5.6 | 6.5 | |
1 to 6 years | 13.8 | 22.2 | 11.3 | |
7 years or more | 80.0 | 72.2 | 82.3 |
3.3. Examination of Treatment Efficacy
3.4. Subgroup Analyses
Symptom Measure | Pre- Versus Post-Treatment | Pre-Treatment Versus 2-Month Follow-Up | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
N | Pre a | Post a | Diff ab | ES | P | N | Pre a | 2-Mo. a | Diff ab | ES | P | |
PTSD Checklist (PCL-C) | 54 | 54.5 (12.2) | 31.2 (11.4) | 22.8 (13.5) | 1.72 | <0.0001 | 54 | 54.5 (12.2) | 30.0 (12.4) | 24.5 (12.4) | 1.98 | <0.0001 |
Brief Symptom Inventory | 52 | 30.8 (14.6) | 10.1 (10.8) | 20.8 (11.9) | 1.74 | <0.0001 | 54 | 30.7 (14.3) | 10.1 (12.1) | 20.7 (13.1) | 1.57 | <0.0001 |
CES-D (Depression) | 54 | 29.5 (10.9) | 11.8 (11.1) | 17.7 (12.5) | 1.41 | <0.0001 | 54 | 29.5 (10.9) | 13.5 (12.1) | 16.0 (11.0) | 1.46 | <0.0001 |
STICSA (Somatic) | 54 | 20.6 (6.9) | 13.8 (3.5) | 6.9 (6.2) | 1.11 | <0.0001 | 54 | 20.6 (6.9) | 14.9 (5.0) | 5.7 (5.2) | 1.10 | <0.0001 |
STICSA (Cognitive) | 54 | 25.2 (6.6) | 15.5 (5.0) | 9.7 (6.0) | 1.62 | <0.0001 | 54 | 25.2 (6.6) | 17.5 (6.8) | 7.7 (6.8) | 1.14 | <0.0001 |
Pittsburgh Sleep Quality | 46 | 9.2 (4.5) | 6.4 (4.4) | 2.4 (3.1) | 0.87 | <0.0001 | 45 | 9.3 (4.6) | 7.0 (4.6) | 2.4 (3.7) | 0.70 | <0.0001 |
Trauma Related Growth | ||||||||||||
Global Guilt | 54 | 4.7 (2.4) | 1.6 (1.9) | 3.1 (2.4) | 1.28 | <0.0001 | 54 | 4.7 (2.4) | 1.9 (2.0) | 2.8 (2.8) | 1.02 | <0.0001 |
Distress | 54 | 18.9 (4.1) | 7.4 (5.9) | 11.2 (6.0) | 1.88 | <0.0001 | 54 | 18.9 (4.1) | 8.2 (5.9) | 10.7 (5.7) | 1.88 | <0.0001 |
Guilt Cognition | 54 | 44.7 (18.6) | 24.1 (13.2) | 20.1 (17.1) | 1.17 | <0.0001 | 54 | 44.7 (18.6) | 24.5 (15.2) | 19.7 (19.0) | 1.04 | <0.0001 |
Post-Traumatic Growth | ||||||||||||
I:Relation to Others | 52 | 12.3 (6.9) | 17.0 (6.6) | 4.8 (4.4) | 0.89 | <0.0001 | 52 | 12.3 (6.9) | 15.3 (6.8) | 3.0 (4.9) | 0.66 | <0.0001 |
II: New Possibilities | 52 | 12.7 (6.5) | 16.9 (6.6) | 4.4 (6.0) | 0.72 | <0.0001 | 52 | 12.7 (6.5) | 15.5 (7.2) | 2.8 (5.5) | 0.53 | 0.0009 |
III: Personal Strength | 52 | 8.5 (5.4) | 11.8 (6.2) | 3.6 (5.5) | 0.63 | <0.0001 | 52 | 8.5 (5.4) | 11.6 (5.6) | 3.1 (4.6) | 0.69 | <0.0001 |
IV: Spiritual Change | 52 | 5.3 (2.9) | 7.2 (2.6) | 2.0 (2.7) | 0.73 | <0.0001 | 52 | 5.3 (2.9) | 6.4 (3.0) | 1.1 (3.1) | 0.36 | 0.008 |
V: Appreciation-Life | 52 | 7.8 (4.0) | 9.6 (4.2) | 2.8 (4.3) | 0.44 | 0.001 | 52 | 7.8 (4.0) | 9.3 (3.9) | 1.5 (4.0) | 0.39 | 0.009 |
Self-Compassion Scale | 54 | 66.8 (16.8) | 84.4 (21.4) | 16.4 (19.9) | 0.82 | <0.0001 | 54 | 66.8 (16.8) | 81.7 (21.8) | 14.9 (17.8) | 0.84 | <0.0001 |
Aggression Questionnaire | 54 | 77.2 (20.2) | 63.9 (20.1) | 13.2 (13.5) | 0.98 | <0.0001 | 54 | 77.2 (20.2) | 64.5 (21.0) | 12.7 (15.0) | 0.85 | <0.0001 |
Alcohol Use (AUDIT) | 52 | 3.0 (3.3) | 2.5 (3.0) | 0.6 (1.8) | 0.26 | 0.03 | 54 | 2.9 (3.3) | 1.8 (2.1) | 1.1 (2.3) | 0.48 | 0.0008 |
3.5. Clinical Interpretation of Treatment Effects
3.6. Medications
3.7. Adverse Events
3.8. Sensitivity Analyses
4. Discussion
4.1. Summary of Findings
4.2. Possible Therapeutic Mechanism
4.3. Systemic Treatment Effects
4.4. Current Treatment Modalities
4.5. Strengths and Limitations
5. Conclusions
Acknowledgements
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Kip, K.E.; Elk, C.A.; Sullivan, K.L.; Kadel, R.; Lengacher, C.A.; Long, C.J.; Rosenzweig, L.; Shuman, A.; Hernandez, D.F.; Street, J.D.; et al. Brief Treatment of Symptoms of Post-Traumatic Stress Disorder (PTSD) by Use of Accelerated Resolution Therapy (ART®). Behav. Sci. 2012, 2, 115-134. https://doi.org/10.3390/bs2020115
Kip KE, Elk CA, Sullivan KL, Kadel R, Lengacher CA, Long CJ, Rosenzweig L, Shuman A, Hernandez DF, Street JD, et al. Brief Treatment of Symptoms of Post-Traumatic Stress Disorder (PTSD) by Use of Accelerated Resolution Therapy (ART®). Behavioral Sciences. 2012; 2(2):115-134. https://doi.org/10.3390/bs2020115
Chicago/Turabian StyleKip, Kevin E., Carrie A. Elk, Kelly L. Sullivan, Rajendra Kadel, Cecile A. Lengacher, Christopher J. Long, Laney Rosenzweig, Amy Shuman, Diego F. Hernandez, Jennifer D. Street, and et al. 2012. "Brief Treatment of Symptoms of Post-Traumatic Stress Disorder (PTSD) by Use of Accelerated Resolution Therapy (ART®)" Behavioral Sciences 2, no. 2: 115-134. https://doi.org/10.3390/bs2020115
APA StyleKip, K. E., Elk, C. A., Sullivan, K. L., Kadel, R., Lengacher, C. A., Long, C. J., Rosenzweig, L., Shuman, A., Hernandez, D. F., Street, J. D., Girling, S. A., & Diamond, D. M. (2012). Brief Treatment of Symptoms of Post-Traumatic Stress Disorder (PTSD) by Use of Accelerated Resolution Therapy (ART®). Behavioral Sciences, 2(2), 115-134. https://doi.org/10.3390/bs2020115