What you believe is what you want: modeling PTSD-related treatment preferences for sertraline or prolonged exposure

J Behav Ther Exp Psychiatry. 2009 Sep;40(3):455-67. doi: 10.1016/j.jbtep.2009.06.001. Epub 2009 Jun 12.

Abstract

Despite the known efficacy of various psychotherapies and pharmacotherapies for posttraumatic stress disorder (PTSD), we know little about what factors predict treatment preference. In the present study, we first developed exploratory path models of treatment preference for a psychotherapy or pharmacotherapy (n=273) and then conducted confirmatory analyses of these models in a second sample (n=324) and in a third generalization sample of trauma-exposed women (n=105). We examined demographic and psychopathology factors and treatment-related beliefs (i.e., credibility and personal reactions). Across all samples, treatment-related beliefs were the strongest predictors of treatment preference. Further, severity of depression directly reduced the likelihood of choosing psychotherapy, and severity of PTSD directly increased the likelihood of choosing pharmacotherapy. These results underscore the importance of better understanding individual's beliefs regarding treatments. With a clearer understanding of these factors, we may be able to reduce barriers to treatment and increase access to effective treatments for those with trauma-related symptoms.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Choice Behavior
  • Female
  • Generalization, Psychological
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Models, Psychological
  • Patient Acceptance of Health Care / psychology*
  • Psychotherapy / methods*
  • Selective Serotonin Reuptake Inhibitors / therapeutic use*
  • Sertraline / therapeutic use*
  • Severity of Illness Index
  • Statistics as Topic
  • Stress Disorders, Post-Traumatic / drug therapy
  • Stress Disorders, Post-Traumatic / psychology*
  • Stress Disorders, Post-Traumatic / therapy*
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Serotonin Uptake Inhibitors
  • Sertraline