Using the Personalized Advantage Index for individual treatment allocation to cognitive behavioral therapy (CBT) or a CBT with integrated exposure and emotion-focused elements (CBT-EE).

Friedl, Nadine; Berger, Thomas; Krieger, Tobias; Caspar, Franz; grosse Holtforth, Martin (2019). Using the Personalized Advantage Index for individual treatment allocation to cognitive behavioral therapy (CBT) or a CBT with integrated exposure and emotion-focused elements (CBT-EE). (In Press). Psychotherapy research, pp. 1-13. Routledge 10.1080/10503307.2019.1664782

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Even though different psychotherapeutic interventions for depression have shown to be effective, patients suffering from depression vary substantially in their treatment response. The goal of this study was to answer the following research questions: (1) What are the most important predictors determining optimal treatment allocation to cognitive behavioral therapy (CBT) or CBT with integrated exposure and emotion-focused elements (CBT-EE)?, and (2) Would model-determined treatment allocation using this predictive information result in better treatment outcomes? Bayesian Model Averaging (BMA) was applied to the data of a randomized controlled trial comparing the efficacy of CBT and CBT-EE in depressive outpatients. Predictions were made for every patient for both treatment conditions and an optimal versus a suboptimal treatment was identified in each case. An index comparing the two estimates, the Personalized Advantage Index (PAI), was calculated. Different predictors were found for both conditions. A PAI of 1.35 BDI-II points for the two conditions was found and 46% of the sample was predicted to have a clinically meaningful advantage in one of the therapies. Although the utility of the PAI approach must be further confirmed in prospective research, the present study study promotes the identification of specific interventions favorable for specific patients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology > Centre of Competence for Psychosomatic Medicine
07 Faculty of Human Sciences > Institute of Psychology > Clinical Psychology and Psychotherapy

UniBE Contributor:

Friedl, Nadine; Berger, Thomas; Krieger, Tobias; Caspar, Franz and grosse Holtforth, Martin

Subjects:

600 Technology > 610 Medicine & health
100 Philosophy > 150 Psychology
700 Arts > 790 Sports, games & entertainment

ISSN:

1050-3307

Publisher:

Routledge

Language:

English

Submitter:

Dania Gioia Spagnuolo

Date Deposited:

26 Sep 2019 14:22

Last Modified:

23 Oct 2019 03:32

Publisher DOI:

10.1080/10503307.2019.1664782

PubMed ID:

31507250

Uncontrolled Keywords:

CBT Personalized Advantage Index depression precision medicine psychotherapy treatment selection

BORIS DOI:

10.7892/boris.133530

URI:

https://boris.unibe.ch/id/eprint/133530

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