Evidence‐based psychotherapies for posttraumatic stress disorder (PTSD), such as cognitive processing therapy and prolonged exposure (CPT/PE), greatly reduce suffering for veterans, but many veterans fail to complete treatment. Developing a theory‐based understanding of adherence is necessary to inform interventions to improve treatment retention. We developed and tested a series of scales applying the theory of planned behavior (TPB) to CPT/PE adherence. The scales were administered in mailed surveys as part of a larger mixed‐methods study of veteran adherence to PE/CPT. Surveys were sent to 379 veterans who were initiating CPT/PE across four U.S. Veterans Affairs (VA) hospitals and 207 of their loved ones. Subsequent session attendance and homework compliance were coded via a review of electronic medical records. We examined item‐level characteristics, factor structure, and the convergent and discriminant validity of the resultant scales. The findings support four subscales: two related to attitudes (i.e., Treatment Makes Sense and Treatment Fits Needs), one related to perceived behavioral control over participation (i.e., Participation Control), and one related to perceived family attitudes about CPT/PE participation (i.e., Subjective Norms). Scale validity was supported through significant associations with theoretically relevant constructs, including intentions to persist in CPT/PE, rs = .19–.38; treatment completion, rs = .21–.25; practical treatment barriers, rs = −.19 to −.24; and therapeutic alliance, rs = .39–.57.

中文翻译：

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以创伤为中心的创伤后应激障碍治疗依从性的计划行为量表理论

创伤后应激障碍 (PTSD) 的循证心理治疗，如认知加工疗法和长时间暴露 (CPT/PE)，大大减轻了退伍军人的痛苦，但许多退伍军人未能完成治疗。发展对依从性的基于理论的理解对于告知干预措施以提高治疗保留率是必要的。我们开发并测试了一系列将计划行为理论 (TPB) 应用于 CPT/PE 依从性的量表。这些量表是在邮寄调查中管理的，作为对退伍军人坚持 PE/CPT 的大型混合方法研究的一部分。调查已发送至美国四家退伍军人事务部 (VA) 医院的 379 名正在启动 CPT/PE 的退伍军人和 207 名他们的亲人。随后的课程出勤率和家庭作业依从性通过审查电子病历进行编码。我们检查了项目级别的特征、因素结构以及所得量表的收敛效度和判别效度。研究结果支持四个子量表：两个与态度相关（即治疗有意义和治疗适合需求），一个与对参与的感知行为控制（即参与控制）相关，一个与对 CPT/PE 参与的感知家庭态度相关。即主观规范）。量表有效性通过与理论相关结构的显着关联得到支持，包括坚持 CPT/PE 的意图，一种与对参与的感知行为控制有关（即参与控制），一种与对 CPT/PE 参与的感知家庭态度有关（即主观规范）。量表有效性通过与理论相关结构的显着关联得到支持，包括坚持 CPT/PE 的意图，一种与对参与的感知行为控制有关（即参与控制），一种与对 CPT/PE 参与的感知家庭态度有关（即主观规范）。量表有效性通过与理论相关结构的显着关联得到支持，包括坚持 CPT/PE 的意图，r s = .19–.38；治疗完成，r s = .21–.25；实际治疗障碍，r s = -.19 至 -.24；和治疗联盟，r s = .39–.57。