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首页> 外文期刊>Psychological trauma: theory, research, practice and policy >Predicting Treatment Dropout Among Veterans Receiving Prolonged Exposure Therapy
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Predicting Treatment Dropout Among Veterans Receiving Prolonged Exposure Therapy

机译：预测接受长期暴露治疗的退伍军人的治疗辍学

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Objective: To examine whether dropout from prolonged exposure (PE) therapy can be predicted from demographic and outcomes data that would typically be available to clinicians. Methods: Dropout was examined in 2,606 patients treated by clinicians in the U.S. Veterans Health Administration PE Training Program. PE typically consists of 8-15 sessions, with 8 sessions being considered a minimum therapeutic dose for most patients. Logistic regression was used to assess the impact of demographics, depression, trauma history, and PE target trauma on risk for dropout. Growth mixture modeling was used to study how posttraumatic stress disorder symptom patterns during the first 5 treatment encounters predicted dropout. Results: In total, 782 patients (30.0%) completed fewer than 8 sessions of PE. Younger veterans were more likely to drop out of PE; odds ratio (OR) per year of age = 0.97, p <.01. Controlling for other factors, veterans who focused on childhood trauma were less likely to drop out than those focusing on combat trauma (OR = 0.51, p <.05). Dropout was unrelated to symptom course or symptom worsening between sessions. Nevertheless, clinicians attributed dropout to distress or avoidance in 45% of the patients who dropped out, citing other factors in 37% of dropout cases. Conclusions: Treatment dropout was predicted by age but not by initial symptom severity or symptom course early in treatment. Symptom exacerbation was rare and did not increase risk of dropout. Nonetheless, clinicians often attributed dropout to patients not tolerating PE.
机译：目的：检查是否可以从人口统计学和成果数据中预测延长暴露（PE）治疗的辍学措施，这些数据通常可供临床医生使用。方法：在美国退伍军医卫生署的临床医生治疗的2,606名患者中检查了辍学。 PE通常由8-15个课程组成，8个课程被认为是大多数患者的最低治疗剂量。 Logistic回归用于评估人口统计，抑郁，创伤史和PE目标创伤对辍学风险的影响。生长混合物建模用于研究前5个治疗期间的错误后应力障碍症状模式如何预测辍学。结果：总共有782名患者（30.0％）完成少于8次PE。年轻的退伍军人更有可能辍学;每年= 0.97，P <.01的差距比（或）。控制其他因素的资深人士的资深人士不太可能辍学，而不是关注战斗创伤（或= 0.51，P <.05）。辍学与会话之间的症状课程或症状无关。尽管如此，临床医生将在45％的患者中归咎于遇险或避免的痛苦或避免，这引用了37％的辍学病例中的其他因素。结论：治疗辍学预期，但不需要初始症状严重程度或症状疗程。症状恶化是罕见的，没有增加辍学风险。尽管如此，临床医生通常将辍学归因于不耐受性的患者。

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