Impact of race on early treatment termination and outcomes in posttraumatic stress disorder treatment.
OBJECTIVE: The present study investigated the influence of race on posttraumatic stress disorder (PTSD) treatment among 94 African American and 214 Caucasian female victims of interpersonal violence participating in 2 studies of cognitive-behavioral treatment for PTSD that were conducted sequentially and continuously. METHOD: In each study, participants were randomized into 1 of 3 conditions. The first study compared cognitive processing therapy with prolonged exposure and a delayed treatment condition. In the second study, cognitive processing therapy was compared with its constituent components: cognitive therapy only and written accounts. Participants were assessed with the Clinician Administered PTSD Scale and the Structured Clinical Interview for DSM-IV, as well as through self-report measures of PTSD. RESULTS: Analyses revealed that African Americans were significantly less likely to complete treatment compared with Caucasians (45% vs. 73%, respectively, p < .001) and that the differences held even after controlling for education and income. Despite racial differences in treatment completion status, analyses with the intent-to-treat sample indicated no racial differences in outcomes on PTSD measures. CONCLUSIONS: The lack of difference in treatment outcomes despite racial differences in dropout may be explained by greater symptom improvement of African Americans who dropped out compared with Caucasians who dropped out. Implications of these findings and practical approaches to addressing sociocultural barriers to care are explored.
Duke Scholars
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Related Subject Headings
- White People
- Treatment Outcome
- Stress Disorders, Post-Traumatic
- Spouse Abuse
- Socioeconomic Factors
- Personality Assessment
- Patient Dropouts
- Middle Aged
- Implosive Therapy
- Humans
Citation
Published In
DOI
EISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- White People
- Treatment Outcome
- Stress Disorders, Post-Traumatic
- Spouse Abuse
- Socioeconomic Factors
- Personality Assessment
- Patient Dropouts
- Middle Aged
- Implosive Therapy
- Humans