Fully remote intensive trauma-focused treatment for PTSD and Complex PTSD

Figures & data

Figure 1. Flowchart of participants.

Table 1. Descriptives of the total sample of patients at baseline: Mean scores of the Clinician Administered PTSD Scale for DSM-5 (CAPS-5), PTSD Checklist for DSM-5 (PCL-5), and International Trauma Questionnaire (ITQ), age and sex, PTSD and Complex PTSD diagnosis, traumatic events according to the Life Events Checklist for DSM-5 (LEC-5), comorbidity, suicidal ideation.

	Total Sample
Variable	n	M	SD	Min.	Max.
CAPS-5 pre-treatment	73	38.71	7.03	24	56
CAPS-5 post-treatment	73	13.12	11.70	0	44
CAPS-5 follow-up	57	15.63	14.70	0	55
PCL-5 pre-treatment	73	45.51	12.09	16	70
PCL-5 post-treatment	61	19.02	16.52	0	70
PCL-5 follow-up	62	21.81	18.40	0	67
ITQ-DSO pre-treatment	70	13.07	5.34	3	22
ITQ-DSO post-treatment	60	6.45	6.08	0	20
ITQ-DSO follow-up	63	7.29	6.60	0	21
Age	73	37.16	11.82	19	63
Sex^1				n	%
Male				11	15,0
PTSD at pre-treatment in accordance with CAPS-5^1				n	%
Patients with PTSD				73	100
CPTSD at pre-treatment in accordance with ITQ^2				n	%
Patients with Complex PTSD				33	47,1
LEC-5^1				n	%
Physical abuse				64	87.7
Sexual abuse				48	65.8
Other traumatic events				44	60.3
Life threatening situations such as accidents				37	50.7
Natural disasters				6	8.2
Warzone situations				5	6.8
One or more Comorbidity^1				n	%
Depressive disorders				39	53.4
Anxiety disorders				40	54.8
Suicidal ideation^1				n	%
Reported moderate to high suicidal risk				19	26.0

¹ n = 73.

² n = 70.

Figure 2. Predicted mean scores of the Clinician Administered PTSD Scale for DSM-5 (CAPS-5) for patients with PTSD and patients with Complex PTSD across the three measurement points (n = 70). Error bars represent 95% CI’s for the mean.

Table 2. Multilevel regression analyses of the Clinician Administered PTSD Scale for DSM-5 (CAPS-5) by measurement moment, age and sex, and Complex PTSD.

	Dependent variable: CAPS-5
	Model 1			Model 2
Predictor	b	SE	p	b	SE	p
Level 1
Pre-treatment (intercept)	35.78	1.41	< .001	35.58	1.44	< .001
Post-treatment	−25.81	1.43	< .001	−24.84	1.97	< .001
Six months follow-up	−23.15	1.76	< .001	−22.62	2.45	< .001
Level 2
Male	2.27	1.27	0.58	1.28	2.28	.58
Age (centred)	0.06	0.07	.38	0.06	0.07	.38
Complex PTSD	4.99	1.69	.004	5.43	1.79	0.004
Participants with missing data	0.71	1.68	.68	0.71	1.69	.68
Interaction Effect
Post x Complex PTSD				−2.07	2.86	.47
Follow-up x Complex PTSD				−1.16	3.54	0.74
	Variances (random effects)
Pre-treatment (intercept)	30.69			30.67
Post-treatment	112.75			111.73
Six months follow-up	162.16			161.20
Residual	12.39			12.36
Level I: number of observations	195			195
Level II: number of participants	70			70
Log Likelihood Ratio-Test	Compared to random Intercept, random slopes Model			Compared to Model 1
Δ χ^2 (df)	53.57 (5)			0.62 (2)
p	< .001			.74
ICC (random intercept only model)	.000

Note¹: Reference group (Intercept); Female, average Age, Completed all measurements, No Complex PTSD, at Pre-Treatment.

Note²: Random Intercept and Random Slope For Measurement Moment for Models 1 and 2.

Figure 3. Predicted mean scores of the PTSD Checklist for DSM-5 (PCL-5) for patients with PTSD and patients with Complex PTSD across the three measurement points (n = 70). Error bars represent 95% CI’s for the mean.

Table 3. Multilevel regression analyses of the PTSD Checklist for DSM-5 (PCL-5) by measurement moment, age and sex, and Complex PTSD.

	Dependent variable: PCL-5
	Model 1			Model 2
Predictor	b	SE	p	b	SE	p
Level 1
Pre-treatment (intercept)	38.19	2.83	< .001	37.01	2.17	< .001
Post-treatment	−26.19	1.92	< .001	−22.65	2.76	< .001
Six months follow-up	−23.02	1.92	< .001	−21.62	2.79	< .001
Level 2
Male	3.86	4.40	0.38	2.92	3.54	.41
Age (centred)	0.16	0.13	0.24	−0.006	0.11	0.96
Complex PTSD	11.03	3.21	< .001	13.01	2.68	< .001
Participants with missing data	2.89	3.25	.038	3.99	2.61	.13
Interaction Effect
Post x Complex PTSD				−7.51	4.02	.06
Follow-up x Complex PTSD				−3.14	4.15	.45
	Variances (random effects)
Pre-treatment (intercept)	73.48			73.65
Post-treatment	218.88			201.27
Six months follow-up	216.75			214.89
Residual	21.51			21.05
Level I: number of observations	190			190
Level II: number of participants	70			70
Log Likelihood Ratio-Test	Compared to random intercept, random slopes Model			Compared to Model 1
Δ χ^2 (df)	37.49 (5)			4.09 (2)
p	< .001			.13
ICC (random intercept only model)	.131

Note¹: Reference group (Intercept); Female, average Age, Completed all measurements, No Complex PTSD, at Pre-Treatment.

Note²: Random Intercept and Random Slope For Measurement Moment for Models 1 and 2.

Table 4. Pairwise comparisons of pre-, post-treatment and follow-up scores for the whole sample.

								Paired samples t-tests
Questionnaire	n	M	SD	Difference	n	Mdifference	SDdifference	t	df	p	Cohen's d
CAPS-5
Pre-treatment	73	38.71	7.04	Pre- to post-treatment	73	−25.59	12.07	18.11	72	< .001	2.12
Post-treatment	73	13.12	11.70	Pre-treatment to follow-up	57	−23.16	14.40	12.14	56	< .001	1.61
Follow-up	57	15.63	14.70	Post-treatment to follow-up	57	2.84	9.29	2.31	56	.025	0.31
PCL-5
Pre-treatment	73	45.51	12.09	Pre- to post-treatment	61	−25.82	16.24	12.42	60	< .001	1.59
Post-treatment	61	19.02	16.52	Pre-treatment to follow-up	62	−22.52	16.06	11.04	61	< .001	1.40
Follow-up	62	21.81	18.40	Post-treatment to follow-up	55	3.20	11.56	2.05	54	.045	0.28
ITQ-DSO
Pre-treatment	70	13.07	5.34	Pre- to post-treatment	59	−6.73	5.72	9.04	58	< .001	1.18
Post-treatment	60	6.45	6.08	Pre-treatment to follow-up	62	−5.69	6.21	7.21	61	< .001	0.92
Follow-up	63	7.29	6.60	Post-treatment to follow-up	55	1.31	4.82	2.01	54	.049	0.27

Table 5. Pairwise comparisons of pre-, post-treatment and follow-up scores for patients with PTSD at pre-treatment.

								Paired samples t-tests
Questionnaire	n	M	SD	Difference	n	Mdifference	SDdifference	t	df	p	Cohen's d
CAPS-5
Pre-treatment	37	36.32	7.08	Pre- to post-treatment	37	−24.84	11.44	13.20	36	< .001	2.17
Post-treatment	37	11.49	10.50	Pre-treatment to follow-up	28	−23.71	13.18	9.52	27	< .001	1.80
Follow-up	28	12.18	11.59	Post-treatment to follow-up	28	2.32	9.20	1.33	27	.19	0.25
PCL-5
Pre-treatment	37	39.14	11.97	Pre- to post-treatment	31	−21.45	16.30	7.33	30	< .001	1.32
Post-treatment	31	16.61	14.29	Pre-treatment to follow-up	33	−21.33	15.31	8.00	32	< .001	1.39
Follow-up	33	16.18	15.55	Post-treatment to follow-up	28	1.25	11.31	0.58	27	.56	0.11
ITQ-DSO
Pre-treatment	37	9.41	4.31	Pre- to post-treatment	31	−4.58	4.77	5.34	30	< .001	0.96
Post-treatment	31	4.77	4.48	Pre-treatment to follow-up	33	−4.24	5.39	4.52	32	< .001	0.79
Follow-up	33	4.89	4.90	Post-treatment to follow-up	28	0.39	3.33	0.63	27	.54	0.12

Table 6. Pairwise comparisons of pre-, post-treatment and follow-up scores for patients with complex PTSD at pre-treatment.

								Paired samples t-tests
Questionnaire	n	M	SD	Difference	n	Mdifference	SDdifference	t	df	p	Cohen's d
CAPS-5
Pre-treatment	33	41.12	6.28	Pre- to post-treatment	33	−26.91	12.30	12.57	32	< .001	2.19
Post-treatment	33	14.21	12.38	Pre-treatment to follow-up	27	−22.85	14.79	8.03	26	< .001	1.55
Follow-up	27	18.48	15.72	Post-treatment to follow-up	27	3.04	9.51	1.66	26	.11	0.32
PCL-5
Pre-treatment	33	51.58	7.82	Pre- to post-treatment	29	−30.76	15.22	10.88	28	< .001	2.02
Post-treatment	29	20.45	17.85	Pre-treatment to follow-up	27	−23.78	16.61	7.44	26	< .001	1.43
Follow-up	27	27.52	18.35	Post-treatment to follow-up	26	4.85	11.75	2.10	25	.046	0.41
ITQ-DSO
Pre-treatment	33	17.18	2.74	Pre- to post-treatment	28	−9.11	4.77	8.29	27	< .001	1.57
Post-treatment	28	7.86	6.88	Pre-treatment to follow-up	29	−7.34	6.75	5.86	28	< .001	1.09
Follow-up	29	9.62	4.90	Post-treatment to follow-up	26	2.35	6.01	1.99	25	.058	0.39

Data availability statement

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly.