Evaluation of cognitive restructuring for post-traumatic stress disorder in people with severe mental illness
Kim T Mueser1, Jennifer D Gottlieb1, Haiyi Xie1
1Kim T. Mueser, PhD, Jennifer D. Gottlieb, PhD, Center for Psychiatric Rehabilitation, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, USA; Haiyi Xie, PhD, Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth, Lebanon, USA, Weili Lu, PhD, Rutgers Biomedical and Health Sciences University, Piscataway, USA; Philip T. Yanos, PhD, John Jay College of Criminal Justice, City University of New York, New York, USA; Stanley D. Rosenberg, PhD, Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth, Lebanon, USA, Steven M. Silverstein, PhD, Stephanie Marcello Duva, PhD, Shula Minsky, PhD, Rutgers University Behavioral Health Care, Piscataway, USA; Rosemarie S. Wolfe, MS, Gregory J. McHugo, PhD, Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth, Lebanon, USA.
Background:
A cognitive-behavioural therapy (CBT) programme designed for post-traumatic stress disorder (PTSD) in people with severe mental illness, including breathing retraining, education and cognitive restructuring, was shown to be more effective than usual services.
Aims:
To evaluate the incremental benefit of adding cognitive restructuring to the breathing retraining and education components of the CBT programme (trial registration: clinicaltrials.gov identifier: NCT00494650).
Method:
In all, 201 people with severe mental illness and PTSD were randomised to 12- to 16-session CBT or a 3-session brief treatment programme (breathing retraining and education). The primary outcome was PTSD symptom severity. Secondary outcomes were PTSD diagnosis, other symptoms, functioning and quality of life.
Results:
There was greater improvement in PTSD symptoms and functioning in the CBT group than in the brief treatment group, with both groups improving on other outcomes and effects maintained 1-year post-treatment.
Conclusions:
Cognitive restructuring has a significant impact beyond breathing retraining and education in the CBT programme, reducing PTSD symptoms and improving functioning in people with severe mental illness.
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