{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T05:06:23Z","timestamp":1777784783079,"version":"3.51.4"},"reference-count":59,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2021,9,29]],"date-time":"2021-09-29T00:00:00Z","timestamp":1632873600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["843001705"],"award-info":[{"award-number":["843001705"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009248","name":"Innovatiefonds Zorgverzekeraars","doi-asserted-by":"publisher","award":["3.180"],"award-info":[{"award-number":["3.180"]}],"id":[{"id":"10.13039\/501100009248","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Differences in effectiveness among treatments for posttraumatic stress disorder (PTSD) are typically small. Given the variation between patients in treatment response, personalization offers a new way to improve treatment outcomes. The aim of this study was to identify predictors of psychotherapy outcome in PTSD and to combine these into a personalized advantage index (PAI). Methods: We used data from a recent randomized controlled trial comparing prolonged exposure (PE; n = 48), intensified PE (iPE; n = 51), and skills training (STAIR), followed by PE (n = 50) in 149 patients with childhood-abuse-related PTSD (CA-PTSD). Outcome measures were clinician-assessed and self-reported PTSD symptoms. Predictors were identified in the exposure therapies (PE and iPE) and STAIR+PE separately using random forests and subsequent bootstrap procedures. Next, these predictors were used to calculate PAI and to retrospectively determine optimal and suboptimal treatment in a leave-one-out cross-validation approach. Results: More depressive symptoms, less social support, more axis-1 diagnoses, and higher severity of childhood sexual abuse were predictors of worse treatment outcomes in PE and iPE. More emotion regulation difficulties, lower general health status, and higher baseline PTSD symptoms were predictors of worse treatment outcomes in STAIR+PE. Randomization to optimal treatment based on these predictors resulted in more improvement than suboptimal treatment in clinician assessed (Cohens\u2019 d = 0.55) and self-reported PTSD symptoms (Cohens\u2019 d = 0.47). Conclusion: Personalization based on PAI is a promising tool to improve therapy outcomes in patients with CA-PTSD. Further studies are needed to replicate findings in prospective studies.<\/jats:p>","DOI":"10.3390\/jcm10194522","type":"journal-article","created":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T00:03:42Z","timestamp":1632960222000},"page":"4522","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Personalization of Treatment for Patients with Childhood-Abuse-Related Posttraumatic Stress Disorder"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5991-1963","authenticated-orcid":false,"given":"Chris M.","family":"Hoeboer","sequence":"first","affiliation":[{"name":"Institute of Psychology, Leiden University, Wassenaarsweg 52, 2333 AK Leiden, The Netherlands"},{"name":"Parnassiagroep, PsyQ, Lijnbaan 4, 2512 VA The Hague, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0832-0581","authenticated-orcid":false,"given":"Danielle A. C.","family":"Oprel","sequence":"additional","affiliation":[{"name":"Institute of Psychology, Leiden University, Wassenaarsweg 52, 2333 AK Leiden, The Netherlands"},{"name":"Parnassiagroep, PsyQ, Lijnbaan 4, 2512 VA The Hague, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rianne A.","family":"De Kleine","sequence":"additional","affiliation":[{"name":"Institute of Psychology, Leiden University, Wassenaarsweg 52, 2333 AK Leiden, The Netherlands"},{"name":"Parnassiagroep, PsyQ, Lijnbaan 4, 2512 VA The Hague, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4695-4953","authenticated-orcid":false,"given":"Brian","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Trier, 54296 Trier, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne-Katharina","family":"Deisenhofer","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Trier, 54296 Trier, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maartje","family":"Schoorl","sequence":"additional","affiliation":[{"name":"Institute of Psychology, Leiden University, Wassenaarsweg 52, 2333 AK Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Willem A. J.","family":"Van Der Does","sequence":"additional","affiliation":[{"name":"Institute of Psychology, Leiden University, Wassenaarsweg 52, 2333 AK Leiden, The Netherlands"},{"name":"Parnassiagroep, PsyQ, Lijnbaan 4, 2512 VA The Hague, The Netherlands"},{"name":"Institute of Psychiatry, Leiden University Medical Center, 2333 AK Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnes","family":"van Minnen","sequence":"additional","affiliation":[{"name":"PSYTREC, Bilthoven, Professor Bronkhorstlaan 2, 3723 MB Bilthoven, The Netherlands"},{"name":"Behavioural Science Institute, Radboud University, 6525 XZ Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5141-3847","authenticated-orcid":false,"given":"Wolfgang","family":"Lutz","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Trier, 54296 Trier, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1002\/jts.20429","article-title":"The Lifetime Prevalence of Traumatic Events and Posttraumatic Stress Disorder in the Netherlands","volume":"22","author":"Olff","year":"2009","journal-title":"J. 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