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Cognitive-behaviour therapy for post-traumatic stress in schizophrenia: a randomised controlled trial

Steel, C., Hardy, A., Smith, B., Wykes, T., Rose, S., Enright, S., Hardcastle, M., Landau, S., Baksh, M. F., Gottlieb, J. D., Rose, D. and Mueser, K. T. (2017) Cognitive-behaviour therapy for post-traumatic stress in schizophrenia: a randomised controlled trial. Psychological Medicine, 47 (1). pp. 43-51. ISSN 1469-8978

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To link to this item DOI: 10.1017/S0033291716002117

Abstract/Summary

Background. There is limited evidence for effective interventions in the treatment of posttraumatic stress symptoms within individuals diagnosed with schizophrenia. Clinicians have concerns about using exposure treatments with this patient group. The current trial was designed to evaluate a 16-session cognitive restructuring programme, without direct exposure, for the treatment of posttraumatic stress symptoms specifically within individuals diagnosed with schizophrenia. Method. A multicentre randomized controlled single-blinded trial with assessments at 0 months, 6-months (post-treatment) and 12 months (follow-up) was conducted. Sixty-one participants diagnosed with schizophrenia and exhibiting posttraumatic stress symptoms were recruited. Those randomized to treatment were offered up to 16 sessions of cognitive behaviour therapy (CBT, including psychoeducation, breathing training and cognitive restructuring) over a 6-month period, with the control group offered routine clinical services. The main outcome was blind rating of posttraumatic stress symptoms using the Clinician Administered PTSD Scale for Schizophrenia (CAPS-S). Secondary outcomes were psychotic symptoms as measured by the Positive and Negative Symptom Scale (PANSS) and the Psychotic Symptom Rating Scale (PSYRATS). Results. Both the treatment and control groups experienced a significant decrease in posttraumatic stress symptoms over time but there was no effect of the addition of CBT on either the primary or secondary outcomes. Conclusions. The current trial did not demonstrate any effect in favour of CBT. Cognitive restructuring programmes may require further adaptation to promote emotional processing of traumatic memories within people diagnosed with a psychotic disorder.

Item Type:Article
Refereed:Yes
Divisions:Faculty of Life Sciences > School of Psychology and Clinical Language Sciences > Department of Psychology
Faculty of Life Sciences > School of Psychology and Clinical Language Sciences > Psychopathology and Affective Neuroscience
ID Code:66287
Publisher:Cambridge University Press

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