OBJECTIVE To compare the course of change in individual posttraumatic stress disorder (PTSD) symptoms during prolonged exposure therapy (PE) and cognitive processing therapy (CPT). METHOD We analyzed data from a previously published randomized clinical trial comparing PE and CPT among male and female U.S. military veterans with PTSD (Schnurr et al., 2022). Using data from a self-rated PTSD symptom measure administered before each therapy session, we evaluated individual symptom change from pretreatment to final therapy session (N = 802). Then, using network intervention analysis, we modeled session-by-session PTSD symptom networks that included treatment allocation (CPT vs. PE) as a node in the networks, allowing us to compare individual symptom change following each session in each treatment. RESULTS Relative to CPT, PE was associated with greater reduction in 10 PTSD symptoms from first to final session of therapy. Numerous treatment-specific effects on individual symptoms emerged during the treatment period; these session-level effects occurred only in symptoms relatively specific to the diagnosis of PTSD (e.g., avoidance, hypervigilance). PE was associated with greater reduction in avoidance following the introduction and early weeks of imaginal exposure. The treatments yielded comparable effects on trauma-related blame and negative beliefs from pretreatment to final therapy session. However, there were differences in session-level change in these symptoms that may reflect differential timing of interventions that reduce distorted cognitions within each treatment. CONCLUSIONS Findings may facilitate the shared decision-making process for patients choosing between CPT and PE. Session-level results provide direction for future research on the specific intervention components of CPT and PE. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

---

认知处理疗法和长期接触对美国退伍军人创伤后应激障碍个体症状的会话水平影响。


目的 比较长期暴露疗法（PE）和认知处理疗法（CPT）期间个体创伤后应激障碍（PTSD）症状的变化过程。方法 我们分析了之前发表的一项随机临床试验的数据，该试验比较了患有 PTSD 的美国男女退伍军人的 PE 和 CPT（Schnurr 等人，2022）。使用每次治疗前进行的自评 PTSD 症状测量数据，我们评估了从治疗前到最终治疗期间的个体症状变化 (N = 802)。然后，使用网络干预分析，我们对逐个疗程的 PTSD 症状网络进行建模，其中包括治疗分配（CPT 与 PE）作为网络中的节点，使我们能够比较每次治疗中每个疗程后的个体症状变化。结果 相对于 CPT，从第一次治疗到最后一次治疗，PE 与 10 种 PTSD 症状的更大程度减少相关。在治疗期间出现了许多针对个体症状的治疗特异性效果；这些会话级效应仅发生在与 PTSD 诊断相对特异的症状中（例如，回避、过度警觉）。 PE与引入想象暴露后和最初几周的回避行为的更大程度减少相关。从治疗前到最后的治疗过程，这些治疗对与创伤相关的责备和消极信念产生了类似的效果。然而，这些症状的疗程水平变化存在差异，这可能反映了减少每次治疗中扭曲认知的干预措施的不同时机。结论 研究结果可能有助于患者在 CPT 和 PE 之间进行选择的共同决策过程。 会议级别的结果为未来 CPT 和 PE 具体干预成分的研究提供了方向。 （PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）。