Prolonged exposure vs supportive counseling for sexual abuse–related PTSD in adolescent girls: A randomized clinical trial

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dc.contributor.authorFoa, E. B., McLean, C. P., Capaldi, S., & Rosenfield, D.
dc.date.accessioned2017-08-08T20:11:38Z
dc.date.available2017-08-08T20:11:38Z
dc.date.issued2013
dc.description.abstractImportance Evidence-based treatments for posttraumatic stress disorder (PTSD) have not been established for adolescents despite high prevalence of PTSD in this population. Objective To examine the effects of counselor-delivered prolonged exposure therapy compared with supportive counseling for adolescents with PTSD. Design, Setting, and Participants A single-blind, randomized clinical trial of 61 adolescent girls with PTSD using a permuted block design. Counselors previously naive to prolonged exposure therapy provided the treatments in a community mental health clinic. Data collection lasted from February 2006 through March 2012. Interventions Participants received fourteen 60- to 90-minute sessions of prolonged exposure therapy (n = 31) or supportive counseling (n = 30). Main Outcomes and Measures All outcomes were assessed before treatment, at mid-treatment, and after treatment and at 3-, 6-, and 12-month follow-up. The primary outcome, PTSD symptom severity, was assessed by the Child PTSD Symptom Scale–Interview (range, 0-51; higher scores indicate greater severity). Secondary outcomes were presence or absence of PTSD diagnosis assessed by the DSM-IV Schedule for Affective Disorders and Schizophrenia for School-Age Children and functioning assessed by the Children’s Global Assessment Scale (range, 1-100; higher scores indicate better functioning). Additional secondary measures, PTSD severity assessed by the Child PTSD Symptom Scale–Self-Report (range, 0-51; higher scores indicate greater severity) and depression severity assessed by the Children’s Depression Inventory (range, 0-54; higher scores indicate greater severity), were also assessed weekly during treatment. Results Data were analyzed as intent to treat. During treatment, participants receiving prolonged exposure demonstrated greater improvement on the PTSD symptom severity scale (difference between treatments in improvement, 7.5; 95% CI, 2.5-12.5; P < .001) and on all secondary outcomes (loss of PTSD diagnosis: difference, 29.3%, 95% CI, 20.2%-41.2%; P = .01; self-reported PTSD severity: difference, 6.2; 95% CI, 1.2-11.2; P = .02; depression: difference, 4.9; 95% CI, 1.6-8.2; P = .008; global functioning: difference, 10.1; 95% CI, 3.4-16.8; P = .008). These treatment differences were maintained through the 12-month follow-up: for interviewer-assessed PTSD (difference, 6.0; 95% CI, 1.6-10.4; P = .02), loss of PTSD diagnosis (difference, 31.1; 95% CI, 14.7-34.8; P = .01), self-reported PTSD (difference, 9.3; 95% CI, 1.2-16.5; P = .02), depression (difference, 7.2; 95% CI, 1.4-13.0; P = .02), and global functioning (difference, 11.2; 95% CI, 4.5-17.9; P = .01). Conclusion and Relevance Adolescents girls with sexual abuse–related PTSD experienced greater benefit from prolonged exposure therapy than from supportive counseling even when delivered by counselors who typically provide supportive counseling.en_US
dc.identifier.citationFoa, E. B., McLean, C. P., Capaldi, S., & Rosenfield, D. (2013). Prolonged exposure vs supportive counseling for sexual abuse–related PTSD in adolescent girls: A randomized clinical trial. Jama, 310(24), 2650-2657.en_US
dc.identifier.urihttp://jamanetwork.com/journals/jama/fullarticle/1793800
dc.identifier.urihttp://hdl.handle.net/11212/3506
dc.language.isoen_USen_US
dc.publisherJAMAen_US
dc.subjectadolescentsen_US
dc.subjectComplex PTSDen_US
dc.subjectEvidence-based treatmenten_US
dc.subjectprolonged exposure therapyen_US
dc.subjecttreatmenten_US
dc.titleProlonged exposure vs supportive counseling for sexual abuse–related PTSD in adolescent girls: A randomized clinical trialen_US
dc.typeArticleen_US

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