Changes in Social Adjustment With Cognitive Processing Therapy: Effects of Treatment and Association With PTSD Symptom Change

Authors

  • Candice M. Monson,

    Corresponding author
    1. Women's Health Sciences Division, U.S. VA National Center for PTSD, Boston, Massachusetts, USA
    • Department of Psychology, Ryerson University, Toronto, Ontario, Canada
    Search for more papers by this author
  • Alexandra Macdonald,

    1. Women's Health Sciences Division, U.S. VA National Center for PTSD, Boston, Massachusetts, USA
    2. Departments of Psychology and Psychiatry, Boston University, Boston, Massachusetts, USA
    Search for more papers by this author
  • Valerie Vorstenbosch,

    1. Department of Psychology, Ryerson University, Toronto, Ontario, Canada
    Search for more papers by this author
  • Philippe Shnaider,

    1. Department of Psychology, Ryerson University, Toronto, Ontario, Canada
    Search for more papers by this author
  • Elizabeth S. R. Goldstein,

    1. Executive Division, U.S. VA National Center for PTSD, White River Junction, Vermont, USA; Department of Psychiatry, Dartmouth Medical School, Hanover, New Hampshire, USA
    Search for more papers by this author
  • Amanda G. Ferrier-Auerbach,

    1. Mental Health Service, Minneapolis VA Healthcare System, Minneapolis, Minnesota, USA
    2. Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota, USA
    Search for more papers by this author
  • Katharine E. Mocciola

    1. Mental Health Service, U.S. VA Maine Healthcare System, Augusta, Maine, USA
    Search for more papers by this author

Correspondence concerning this article should be addressed to Candice M. Monson, Department of Psychology, Ryerson University, 350 Victoria St., Toronto, ON M5B 2K3, Canada. E-mail: candice.monson@psych.ryerson.ca

Abstract

The current study sought to determine if different spheres of social adjustment, social and leisure, family, and work and income improved immediately following a course of cognitive processing therapy (CPT) when compared with those on a waiting list in a sample of 46 U.S. veterans diagnosed with posttraumatic stress disorder (PTSD). We also sought to determine whether changes in different PTSD symptom clusters were associated with changes in these spheres of social adjustment. Overall social adjustment, extended family relationships, and housework completion significantly improved in the CPT versus waiting-list condition, η2 = .08 to .11. Hierarchical multiple regression analyses revealed that improvements in total clinician-rated PTSD symptoms were associated with improvements in overall social and housework adjustment. When changes in reexperiencing, avoidance, emotional numbing, and hyperarousal were all in the model accounting for changes in total social adjustment, improvements in emotional numbing symptoms were associated with improvements in overall social, extended family, and housework adjustment (β = .38 to .55). In addition, improvements in avoidance symptoms were associated with improvements in housework adjustment (β = .30), but associated with declines in extended family adjustment (β = −.34). Results suggest that it is important to consider the extent to which PTSD treatments effectively reduce specific types of symptoms, particularly emotional numbing and avoidance, to generally improve social adjustment.

Ancillary