Temperamental traits as predictors of effectiveness of psychotherapy (prolonged exposure) for PTSD in a group of motor vehicle accident survivors

Abstract

Background The aim of the study was to analyze demographic (age, gender and education), temperamental (briskness and emotional reactivity) and psychopathological (severity of the disorder, comorbid symptoms of personality disorders) predictors of effectiveness of psychotherapy (Prolonged Exposure; PE) of posttraumatic stress disorder (PTSD). It was expected that temperamental traits – briskness (BR) and emotional reactivity (ER) (involved in arousing and change of PTSD symptoms) – would predict the post-treatment diagnosis of PTSD, regardless of severity of PTSD and symptoms of personality disorders. Participants and procedure The logistic regression done on findings obtained in the com­bined sample of 123 motor vehicle accident (MVA) survivors, participating in PE within randomized and non-randomized trials. Results A significant effect of severity of pre-treatment PTSD (lower rate of remission in subjects with more severe PTSD), briskness (higher rate of remission in high BR subjects) and interaction between ER and time after MVA (lower rate of remission in high ER subjects treated in a longer period after MVA) were observed. The effect of personality disorders was not significant due to the remarkable correlations with other predictors. Conclusions In the discussion the possible mechanisms of the impact of temperamental traits on recovery from PTSD under psychotherapy are suggested, including behavioral plasticity (briskness) and the relationship between subjects’ moti­vation for treatment and the opportunity of successful recovery (determined by comorbid personality disorders), explaining the interactional effect of emotional reactivity.