Contract grant sponsor: NIMH; Contract grant number: 2-R01-MH51509 to PAS.
THE IMPACT OF DISSOCIATION ON PTSD TREATMENT WITH COGNITIVE PROCESSING THERAPY
Article first published online: 30 MAR 2012
© 2012 Wiley Periodicals, Inc.
Depression and Anxiety
Volume 29, Issue 8, pages 718–730, August 2012
How to Cite
Resick, P. A., Suvak, M. K., Johnides, B. D., Mitchell, K. S. and Iverson, K. M. (2012), THE IMPACT OF DISSOCIATION ON PTSD TREATMENT WITH COGNITIVE PROCESSING THERAPY. Depress. Anxiety, 29: 718–730. doi: 10.1002/da.21938
- Issue published online: 1 AUG 2012
- Article first published online: 30 MAR 2012
- Manuscript Accepted: 10 FEB 2012
- Manuscript Revised: 12 JAN 2012
- Manuscript Received: 2 SEP 2011
- posttraumatic stress disorder;
- cognitive processing therapy;
- randomized controlled trial
This secondary analysis of data from a randomized controlled trial of cognitive processing therapy (CPT) and its constituent components investigated whether dissociation decreased over the course of treatment primarily targeting symptoms of posttraumatic stress disorder (PTSD) and explored whether levels of dissociation predicted treatment outcome differentially by treatment condition.
An intention to treat sample of 150 women were randomized to CPT, cognitive therapy only (CPT-C) or written trauma accounts only (WA). Dissociation was measured by the dissociation subscale of the Traumatic Stress Inventory and the Multiscale Dissociation Inventory.
Multilevel regression analyses revealed significant decreases in dissociation that did not vary as a function of treatment condition. Growth curve modeling revealed significant treatment condition by dissociation interactions such that the impact of pretreatment levels of dissociation impacted the treatment conditions differently.
Women who endorsed low pretreatment levels of dissociation responded most efficiently to CPT-C, whereas women with the highest levels of dissociation, in particular high levels of depersonalization, responded better to CPT.