title: Predictors of outcome of an Internet-based cognitive-behavioural therapy for post-traumatic stress disorder in older adults.
abstract: OBJECTIVE
  The aim of this study was to evaluate the role of resource-oriented variables such as self-efficacy, locus of control (LOC) and post-traumatic growth (PTG) in predicting treatment response in older adults with post-traumatic stress.
  
  
  METHODS
  Fifty-eight older adults with subsyndromal or greater severity of war-associated post-traumatic stress disorder (PTSD) symptoms completed a randomized controlled Internet-based cognitive-behavioural therapy (CBT) with immediate and delayed treatment groups. Assessments of PTSD severity and resource-oriented variables of self-efficacy, LOC and PTG were conducted at baseline, post-treatment and at a 6-month follow-up.
  
  
  RESULTS
  Results revealed that pre-treatment scores on measures of internal LOC and PTG predicted PTSD symptom severity at post-treatment, even after controlling for initial PTSD. At a 6-month follow-up, internal LOC continued to predict PTSD symptom severity. In addition, repeated-measures analyses of variance revealed that, relative to older adults with low internal LOC and PTG, older adults with high internal LOC and PTG, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment.
  
  
  CONCLUSIONS
  These findings suggest that greater locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Assessment of these constructs may be useful in identifying trauma survivors who are most likely to respond to CBT.
  
  
  CONCLUSIONS
  Greater internal locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Older adults with initial high internal locus of control and post-traumatic growth, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment. It could be assumed that patients with initial functional appraisals could benefit easier and faster from a trauma-focused cognitive-behavioural therapy compared to individuals with lower internal locus of control and post-traumatic growth.
authors.affiliation: Berlin Center for Torture Victims, Berlin, Germany.|Department of Clinical Psychology and Psychotherapy, Freie University Berlin, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Böttche
authors.affiliation: Department of Psychiatry and Psychotherapy at the HELIOS Hansehospital Stralsund, Ernst-Moritz-Arndt-University, Greifswald, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Kuwert
authors.affiliation: National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut, USA.|Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Pietrzak
authors.affiliation: Berlin Center for Torture Victims, Berlin, Germany.|Department of Clinical Psychology and Psychotherapy, Freie University Berlin, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Knaevelsrud
mesh_terms: D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007389:Internal-External Control; D020407:Internet; D008297:Male; D055500:Resilience, Psychological; D020377:Self Efficacy; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires; D013813:Therapy, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome
keywords: elderly; post-traumatic stress disorder; prediction; resource-oriented variables; treatment outcome