title: Object relations as a predictor of treatment outcome with chronic posttraumatic stress disorder.
abstract: The role of object relations as a predictor of outcome was evaluated in inpatient posttraumatic stress disorder (PTSD) treatment. Cohort outcome at discharge on psychometric indices was mixed, with limited evidence of reliable or clinically significant change. Treatment was associated with an overall reduction in utilization of inpatient psychiatric and residential domiciliary services. However, moderate (vs. low) levels of object relations were predictive of reliable change outcome, independent of demographics, Axis II diagnosis, symptomatic severity, or early childhood or war zone trauma exposure. The findings suggest that consideration should be given both to the manner in which patients seeking treatment for PTSD are screened and matched with a range of treatment or rehabilitation services and to how treatment outcome is conceptualized beyond symptom reduction. Rehabilitation of chronic posttraumatic symptomatology and associated psychosocial impairment may be facilitated by assessment, treatment design, and client-treatment matching on the basis of multidimensional psychological indices.
authors.affiliation: Department of Veterans Affairs, National Center for PTSD, White River Junction, Vermont 05009, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Ford
authors.forename: P
authors.initials: P
authors.lastname: Fisher
authors.forename: L
authors.initials: L
authors.lastname: Larson
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003130:Combat Disorders / Q000175:diagnosis / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009769:Object Attachment; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D012114:Residential Treatment / Q000379:methods / Q000592:standards*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000534:rehabilitation*; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology*