Direction of influence between posttraumatic and depressive symptoms during prolonged exposure therapy among children and adolescents.
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OBJECTIVE: Our objective in the present study was to examine the temporal sequencing of posttraumatic and depressive symptoms during prolonged exposure therapy for posttraumatic stress disorder (PTSD) among children and adolescents. METHOD: Participants were 73 children and adolescents (56.2% female) between the ages of 8 and 18. Participants completed self-report measures of posttraumatic stress and depression prior to every session. Measures included the Child PTSD Symptom Scale, Beck Depression Inventory, and Children's Depression Inventory. RESULTS: Multilevel mediational analyses indicated reciprocal relations during treatment: Changes in posttraumatic symptoms led to changes in depressive symptoms and vice versa. Posttraumatic symptoms accounted for 64.1% of the changes in depression, whereas depressive symptoms accounted for 11.0% of the changes in posttraumatic stress. CONCLUSIONS: Prolonged exposure therapy may work primarily by reducing posttraumatic stress, which in turn reduces depression.
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The mediator and outcome variable were time lagged to conduct a more rigorous test of mediation in which the mediator temporally precedes the outcome.
“The mediator and outcome variable were time lagged (Aderka, Foa, Applebaum, Shafran, & Gilboa-Schechtman, 2011; Bomyea et al., 2015) in order to conduct a more rigorous test of mediation in which the mediator temporally precedes the outcome (Kazdin, 2007).”
From Enhancing social connectedness in anxiety and depression through amplification of positivity: Preliminary treatment outcomes and process of change (2020) · cites this paper as Aderka, Foa, Applebaum, Shafran, & Gilboa-Schechtman, 2011
To conduct a more rigorous test of mediation in which the mediator temporally precedes the outcome, the mediator and outcome variable were time lagged.
“To conduct a more rigorous test of mediation in which the mediator temporally precedes the outcome (Kazdin, 2007), we time lagged the mediator and outcome variable (Aderka et al., 2011; Donegan & Dugas, 2012; Bomyea et al., 2015).”
From The affective tie that binds: Examining the contribution of positive emotions and anxiety to relationship formation in social anxiety disorder (2017) · cites this paper as Aderka et al., 2011
All models described were time-lagged, with the slope of the hypothesized intervening variables (pleasantness and anxiety) at time t and the slope of the outcome (connectedness) at time t+1.
“Note that all models described above were time-lagged. That is, we examined the slope of the hypothesized intervening variables (pleasantness and anxiety) at time t, whereas the slope of the outcome (connectedness) was examined at time t+1.”
From The affective tie that binds: Examining the contribution of positive emotions and anxiety to relationship formation in social anxiety disorder (2017) · cites this paper as Aderka et al., 2011
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- Authors
- Aderka, I. M., Foa, E. B., Applebaum, E., Shafran, N., & Gilboa-Schechtman, E.
- Affiliations
- Boston University (US)
- University of Pennsylvania (US)
- Bar-Ilan University (IL)
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2011-06
- Volume
- 79
- Issue
- 3
- Pages
- 421-425
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- PMC
- PMC3109111
- OpenAlex
- W2004781978
- Cited by
- 64
- References
- 27
- Citations by year
- 2026: 1 · 2024: 4 · 2023: 2 · 2022: 5 · 2021: 3 · 2020: 4 · 2019: 6 · 2018: 4 · 2017: 4 · 2016: 5 · 2015: 11 · 2014: 5 · 2013: 3 · 2012: 7
- FWCI
- 5.18
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- University of Pennsylvania
- National Institute of Mental Health (R34MH071660)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- prolonged exposure therapy, post-traumatic stress disorder, depression, depressive symptoms, posttraumatic stress symptoms, bidirectional relationship, children and adolescents, therapeutic mechanisms
- MeSH terms
- Adolescent, Child, Depression, Depressive Disorder, Female, Humans, Implosive Therapy, Male, Stress Disorders, Post-Traumatic, Treatment Outcome
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