Category: PTSD

Symposium

Higher Hopes, Faster Gains: The Effect of Outcome Expectancy on Prolonged Exposure Treatment Response

Saturday, November 18
1:45 PM - 3:15 PM
Location: Sapphire Ballroom O & P, Level 4, Sapphire Level

Keywords: Prolonged Exposure | Trauma | Psychotherapy Process
Presentation Type: Symposium

Background: Outcome expectancy, defined as the patient’s prognostic beliefs about the likely success of treatment, is widely considered an important cognitive variable that influences treatment engagement and response. However, few studies have investigated the expectancy-outcome relationship in the context of PTSD treatment. Objective: The current study examines the impact of outcome expectancy (OE) on patient response to Prolonged Exposure Therapy (PE) for posttraumatic stress disorder (PTSD). Method: Participants (n=63) were adult smokers with PTSD (63.9% male; Mage= 42.8 years) who received PE in the context of a randomized controlled trial evaluating smoking cessation and PTSD treatment integration. All participants received varenicline, PE, and smoking cessation counseling over 12 weeks. Multilevel models examined the effects of OE on session-by-session PTSD and depression rates of change, with observations nested with participants.  Results: Higher OE was significantly associated with both faster decline in PTSD symptoms and lower PTSD severity throughout the course of PE, but effects were more pronounced at post-treatment than at 15 week follow-up. In contrast, OE was not predictive of rates of reduction in depression. Conclusions: Patient beliefs about the likely success of treatment appear to significantly impact the trajectory of symptom change, but only on the principal disorder being targeted in treatment. Low OE signals slower response to treatment, but not necessarily poorer long-term PE outcomes.

Laurie Zandberg

Assistant Professor
University of Pennsylvania, Center for the Treatment and Study of Anxiety

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