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Predictors of outcome of an Internet‐based cognitive‐behavioural therapy for post‐traumatic stress disorder in older adults
Author(s) -
Böttche Maria,
Kuwert Philipp,
Pietrzak Robert H.,
Knaevelsrud Christine
Publication year - 2016
Publication title -
psychology and psychotherapy: theory, research and practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.102
H-Index - 62
eISSN - 2044-8341
pISSN - 1476-0835
DOI - 10.1111/papt.12069
Subject(s) - traumatic stress , cognition , clinical psychology , psychology , the internet , outcome (game theory) , medicine , psychiatry , computer science , world wide web , mathematics , mathematical economics
Objectives The aim of this study was to evaluate the role of resource‐oriented variables such as self‐efficacy, locus of control ( LOC ) and post‐traumatic growth ( PTG ) in predicting treatment response in older adults with post‐traumatic stress. Methods Fifty‐eight older adults with subsyndromal or greater severity of war‐associated post‐traumatic stress disorder ( PTSD ) symptoms completed a randomized controlled Internet‐based cognitive‐behavioural therapy ( CBT ) with immediate and delayed treatment groups. Assessments of PTSD severity and resource‐oriented variables of self‐efficacy, LOC and PTG were conducted at baseline, post‐treatment and at a 6‐month follow‐up. Results Results revealed that pre‐treatment scores on measures of internal LOC and PTG predicted PTSD symptom severity at post‐treatment, even after controlling for initial PTSD . At a 6‐month follow‐up, internal LOC continued to predict PTSD symptom severity. In addition, repeated‐measures analyses of variance revealed that, relative to older adults with low internal LOC and PTG , older adults with high internal LOC and PTG , respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment. Conclusion These findings suggest that greater locus of control and post‐traumatic growth is associated with greater improvement in PTSD symptoms following Internet‐based CBT . Assessment of these constructs may be useful in identifying trauma survivors who are most likely to respond to CBT . Practitioner points Greater internal locus of control and post‐traumatic growth is associated with greater improvement in PTSD symptoms following Internet‐based CBT . Older adults with initial high internal locus of control and post‐traumatic growth, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment. It could be assumed that patients with initial functional appraisals could benefit easier and faster from a trauma‐focused cognitive‐behavioural therapy compared to individuals with lower internal locus of control and post‐traumatic growth