Examining the associations between posttraumatic stress disorder symptom clusters across cognitive processing
Casey L May1, Laura Stayton-Coe1, Kathleen M Chard1,2
1Trauma Recovery Center, Cincinnati Veterans Affairs Medical Center, Cincinnati, Ohio, USA.
Journal of Traumatic Stress
|October 25, 2024
Summary
Early improvements in negative alterations in cognitions and mood (NACM) during cognitive processing therapy (CPT) correlate with later reductions in avoidance and other PTSD symptoms. These findings offer insights into symptom change dynamics in CPT for veterans.
Area of Science:
- Psychology
- Clinical Psychology
- Trauma Studies
Background:
- Cognitive Processing Therapy (CPT) is a leading trauma-focused intervention for Posttraumatic Stress Disorder (PTSD).
- CPT theorizes that altered cognitions are the primary mechanism for symptom improvement.
- Understanding the temporal relationships between PTSD symptom clusters during CPT is crucial for optimizing treatment.
Purpose of the Study:
- To investigate the associations between changes in distinct PTSD symptom clusters during a 7-week CPT program.
- To test the hypothesis that early improvements in negative alterations in cognitions and mood (NACM) predict later changes in other symptom clusters.
Main Methods:
- Cross-lagged path analyses were employed.
- Data from 296 veterans in a residential PTSD treatment program were analyzed.
- PTSD symptoms were assessed at pretreatment, midtreatment (Week 4), and posttreatment (Week 7).
Main Results:
- Early improvements in NACM were associated with later reductions in avoidance symptoms.
- Improvements in intrusions and arousal also correlated with subsequent decreases in avoidance.
- A bidirectional relationship was observed between arousal and intrusions, and between NACM and avoidance.
Conclusions:
- Early changes in specific PTSD symptom clusters, particularly NACM, arousal, and intrusions, are linked to subsequent improvements in other clusters, notably avoidance.
- These findings highlight the interconnectedness of symptom clusters within CPT and suggest potential targets for early intervention.
- Understanding these temporal dynamics can inform personalized treatment planning and enhance CPT efficacy for PTSD.
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