Predicting treatment outcome for complex posttraumatic stress disorder using the personalized advantage index

Background

Many studies show that psychotherapy can help people with posttraumatic stress disorder (PTSD). However, not everyone responds the same way to treatment, especially those with complex PTSD (CPTSD). We need better ways to match patients to the treatments that will help them the most.

Objective

The goal of this study was to create a Personalized Advantage Index (PAI). This index uses clinical and demographic factors to predict which treatment—exposure therapy or skills training—will work best for each patient with CPTSD.

Method

The researchers used data from a previous study involving 92 patients diagnosed with CPTSD. They compared two types of treatments: Prolonged Exposure (PE) and Skills Training in Affective and Interpersonal Regulation (STAIR). They measured treatment outcomes by looking at both clinician assessments and patient self-reports of PTSD symptoms. They also identified factors that predicted treatment success for each therapy.

Results

For PE, factors like somatoform dissociation, depression, suicidal thoughts, and poor physical health indicated a worse outcome. For STAIR, issues like interpersonal problems and high PTSD symptom severity were negative predictors, while witnessing trauma was a positive predictor. When patients were matched to the right treatment using the PAI, they showed significant improvements in PTSD symptoms—large improvements with clinician assessments and moderate improvements with self-reports.

Conclusions

The PAI shows promise for personalizing psychological treatments for CPTSD, potentially leading to better outcomes. More research with larger groups is necessary to validate this approach.

Opportunities Based on Trial Data

We can define measurable outcomes and set clear goals for predicting treatment success in clinics and for patients using the Personalized Advantage Index.