The goal of this clinical trial is to learn if a treatment for adults with PTSD called prolonged exposure + incentives (PE+) works to treat pregnant patients. The main question it aims to answer is: Does PE+ decrease PTSD symptoms? All participants will receive PE+ to see if their PTSD symptoms at the end of the trial are less than at the beginning. Participants will: * Receive individual PE+ therapy for 1 hour weekly for 12 weeks. * Receive financial incentives for attending each PE+ session. * Attend assessment visits every 4 weeks for the 12 weeks of the trial. * Allow research staff to collect some information about their labor and delivery from their medical records after their babies are born.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
30
Prolonged exposure therapy plus incentives for therapy session attendance
University of Vermont
Burlington, Vermont, United States
Change in Posttraumatic Stress Disorder Symptom Severity - Clinician Rated
Change in posttraumatic stress disorder symptom severity as measured by Clinician Administered PTSD Scale (CAPS-5) for clinician-rated posttraumatic stress symptoms. The CAPS-5 is a 30-item structured interview. CAPS-5 total symptom severity score is calculated by summing severity scores for the 20 PTSD symptoms, each with severity scores ranging from 0-4. The overall total severity score for CAPS-5 ranges from 0-80, with lower scores representing better outcomes (less severe PTSD).
Time frame: From baseline to the 12-week assessment
Acceptability of prolonged exposure therapy + incentives for therapy session attendance
Change in treatment acceptability as measured by the Treatment Acceptability/Adherence Scale (TAAS). The TAAS is a 10-item scale, each with a range of 1-7 and some of which are reverse-scored. The total TAAS score is calculated by summing the score for the 10 TAAS items and the overall TAAS score ranges from 10-70, with higher scores representing better outcomes (greater treatment acceptability).
Time frame: From baseline to the 12-week assessment
Change in posttraumatic stress disorder symptom severity - self-reported
Change in posttraumatic stress disorder symptom severity as measured by PTSD Checklist for DSM-5 (PCL-5) for self-reported posttraumatic stress symptoms. The PCL-5 is a 20-item self-report measure that assesses the 20 symptoms of PTSD. The rating scale is 0-4 for each symptom/item, and overall scores range from 0-80, with lower scores representing better outcomes (less severe PTSD).
Time frame: From baseline to the 12-week assessment
Mean change in subjective units of distress
The mean change in subjective units of distress scale (SUDS) ratings from before each imaginal exposure exercise to the peak (highest) level of distress reported during the exercise measured with a single item (range: 0-100).
Time frame: Within 1-hour
Mean percent change in heart rate
The mean percent change in heart rate from before each imaginal exposure exercise to peak (highest) heart rate during the exercise
Time frame: Within 1-hour
Change in self-reported posttraumatic stress disorder symptom severity between PE sessions
The percentage of participants who have a reliable exacerbation in PTSD symptoms between sessions
Time frame: In the 1 week
Prolonged exposure therapy discontinuation
The percentage of participants who complete \<8 prolonged exposure therapy sessions
Time frame: From baseline to the 12-week assessment
Neonatal birth weight
Neonatal birth weight in grams
Time frame: Delivery
Gestational age at delivery
Gestational age at delivery in weeks
Time frame: Delivery
Maternal delivery complications
The percentage of participants who experience delivery complications (i.e., abruption/bleeding, hypertensive disorders, and preterm premature rupture of membranes or preterm labor)
Time frame: Delivery
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