Metacognitive Therapy Versus Prolonged Exposure in Adults with Chronic Post-traumatic Stress Disorder: A Parallel Randomized Controlled Trial

Abstract

A parallel randomized controlled trial compared metacognitive therapy (MCT) with prolonged exposure (PE) in 32 patients with PTSD of ≥3 months duration. Participants were assigned to; eight sessions of therapy (MCT or PE) or an 8-week wait period (WL). There was only one drop-out from each treatment. Both active treatments were effective, resulting in significantly lower symptoms of PTSD, anxiety and depression compared with the WL. At post-treatment MCT was superior to PE on self-report symptoms of PTSD and superior to WL on objective measures of hyper-arousal (heart-rate). Recovery rates and reliable improvement in both MCT and PE were high. MCT exerted effects more rapidly and within group effect sizes in MCT were much larger than those in PE at the end of treatment. Clinical gains remained evident at follow-up by which time the treated groups did not differ. In conclusion; both treatments were effective but MCT had a clear advantage. The clinical implications and suggestions for future research are discussed.

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Conflict of Interest

Adrian Wells, Deborah Walton, Karina Lovell and Dawn Proctor declared that they have no conflict of interest.

Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000(5). Informed consent was obtained from all patients before being included in the study.

Animal Rights

No animal studies were carried out by the authors for this article.

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Correspondence to Adrian Wells.

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International Clinical Trials Registry Platform NHSTCT Register: ISRCTN63706856.

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Wells, A., Walton, D., Lovell, K. et al. Metacognitive Therapy Versus Prolonged Exposure in Adults with Chronic Post-traumatic Stress Disorder: A Parallel Randomized Controlled Trial. Cogn Ther Res 39, 70–80 (2015). https://doi.org/10.1007/s10608-014-9636-6

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Keywords

  • Posttraumatic stress disorder
  • Clinical trials
  • Cognitive-behavior therapy
  • Metacognitive therapy
  • Prolonged exposure