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. 2023 Aug;36(4):668-681.
doi: 10.1002/jts.22963. Epub 2023 Aug 7.

Exploring trajectories in transdiagnostic behavior therapy

Daniel F Gros  1   2 , Kevin G Saulnier  3   4   5 , Nicholas P Allan  6   7
Affiliations

Exploring trajectories in transdiagnostic behavior therapy

Daniel F Gros et al. J Trauma Stress. 2023 Aug.

Abstract

Transdiagnostic treatments have been designed to target common processes for clusters of disorders. One such treatment, transdiagnostic behavior therapy (TBT), targets avoidance across emotional disorders, including posttraumatic stress disorder (PTSD), depressive disorders, and anxiety disorders, and has demonstrated efficacy in randomized controlled trials. The current study was designed to examine whether distinct treatment trajectories would emerge in a sample of 112 veterans receiving TBT and whether diagnostic comorbidity, baseline levels of several transdiagnostic risk factors, or treatment engagement influence trajectory membership. Growth mixture modeling revealed three distinct trajectories across depression, ds = 0.55-1.09; PTSD ds = -0.07-1.43; and panic disorder symptoms, ds = -0.13-1.09. Notably, for PTSD and panic disorder symptoms, separate classes for responders and nonresponders emerged among participants with high baseline symptom levels. Findings for the risk factors suggested that PTSD and panic nonresponders evidenced significantly higher behavioral avoidance at baseline and reduced engagement in treatment procedures and homework completion compared to responders. Together, the findings provide additional support for the use of TBT in the treatment of emotional disorders, including PTSD. Potential adaptations are discussed for patients with significantly elevated behavioral avoidance to improve treatment engagement and related outcomes.

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Conflict of interest statement

The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the VA or the United States government. There are no conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Estimated depressive symptom trajectories of high-responder (n = 22), moderate-responder (n = 64), and low-responder (n = 23) classes Note: PHQ-9 = nine-item Patient Health Questionnaire.
FIGURE 2
FIGURE 2
Estimated posttraumatic stress disorder (PTSD) symptom trajectories of high-nonresponder (n = 20), high-responder (n = 14), and moderate-responder (n = 71) classes Note: PCL-5 = PTSD Checklist for DSM-5.
FIGURE 3
FIGURE 3
Estimated panic trajectories of high-nonresponder (n = 21), high-responder (n = 10), and moderate-responder (n = 74) classes Note: PDSS = Panic Disorder Severity Scale.
See this image and copyright information in PMC

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