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Identifying patterns of symptom change during a randomized controlled trial of cognitive processing therapy for military-related posttraumatic stress disorder

Authors

  • Alexandra Macdonald,

    Corresponding author
    1. Boston University and VA Boston Healthcare System
    Current affiliation:
    1. Psychology Department, Boston University, and VA Boston Healthcare System
    • VA Boston Healthcare System (116B), 150 S. Huntington Avenue, Jamaica Plain, MA
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  • Candice M. Monson,

    1. National Center for Posttraumatic Stress Disorder
    Current affiliation:
    1. Women's Health Science Division, National Center for Posttraumatic Stress Disorder
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    • Candice M. Monson is now at the Department of Psychology, Ryerson University.

  • Susan Doron-Lamarca,

    1. National Center for Posttraumatic Stress Disorder
    Current affiliation:
    1. Behavioral Science Division, National Center for Posttraumatic Stress Disorder
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  • Patricia A. Resick,

    1. National Center for Posttraumatic Stress Disorder
    Current affiliation:
    1. Women's Health Science Division, National Center for Posttraumatic Stress Disorder
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  • Tibor P. Palfai

    1. Boston University
    Current affiliation:
    1. Psychology Department, Boston University
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  • This research was supported by a Clinical Research Career Development Award to the second author from the VA Cooperative Studies Program. We are deeply appreciative of the veterans willing to contribute to this research effort. We would also like to thank Drs. Paula P. Schnurr and Matthew J. Friedman, mentors for the parent study, at the VA National Center for PTSD, Executive Division, and mental health staff at the White River Junction VA Medical and Regional Office Center and White River Junction Vet Center. Our thanks also go to Mr. Gary Johnson, Dr. Nancy Bernardy, Dr. Kelley Callahan, Mr. Brady Cole, Dr. Jason DeViva, Dr. Matthew Feldner, Ms. Heather Myers, Ms. Megan Newton, Dr. Jennifer L. Price, Dr. Elizabeth Ranslow, Ms. Anka Vujanovic, and Ms. Sandra Torres.

Abstract

Cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) has been shown to reduce symptoms of PTSD in a veteran population. This study explored patterns of self-reported symptom change during CPT. Veterans (N = 60) with PTSD were randomized to receive CPT immediately or after 10 weeks. We hypothesized that those treated immediately would evidence initial symptom stability followed by decline compared with those who waited, whose PTSD symptoms would remain stable. The best model fit based on deviance statistics and Bayesian information criteria comparisons was one in which participants treated immediately showed more rapid initial decline followed by a slower rate of PTSD symptom improvement relative to those who waited, who showed a stable level of symptomatology. Findings suggest that CPT produces quick and maintained improvements in veterans. The effect sizes for change between those who received CPT immediately and those who waited were approximately medium sized. Implications of findings are discussed.

Traditional and Simplified Chinese Abstracts by AsianSTSS

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