A Randomized Clinical Trial of Cognitive Processing Therapy for Veterans With PTSD Related to Military Sexual Trauma


  • Grant support was received from the Veterans Administration Rehabilitation Research & Development Service, Clinical trial #NCT00371644 at http://clinicaltrials.gov/

Correspondence concerning this article should be addressed to Alina Surís, Dallas VA Medical Center, Mental Health (116A), 4500 S. Lancaster Rd., Dallas, TX 75216. E-mail: alina.suris@va.gov


In this randomized controlled clinical trial, the authors evaluated the effectiveness of cognitive processing therapy (CPT) in the treatment of self-reported and clinician-assessed posttraumatic stress disorder (PTSD) related to military sexual trauma (MST), along with depressive symptoms. Eighty-six veterans (73 female, 13 male) randomly assigned to receive 12 individual sessions of either CPT or present-centered therapy (PCT) were included in analyses. Blinded assessments occurred at baseline, posttreatment, and 2, 4, and 6 months posttreatment. Mixed-effects model analysis revealed a significant interaction between groups (p = .05, d = −0.85): At posttreatment, veterans who received CPT had a significantly greater reduction in self-reported, but not clinician-assessed, PTSD symptom severity compared to veterans who received PCT. All three primary outcome measures improved significantly, both clinically and statistically, across time in both treatment groups. Pre- and posttreatment effect sizes were mostly moderate to large (d = 0.30–1.02) and trended larger in the CPT group. Although the study was impacted by treatment fidelity issues, results provide preliminary evidence for the effectiveness of CPT in reducing self-reported PTSD symptoms in a population of veterans with MST, expanding on established literature that has demonstrated the effectiveness of CPT in treating PTSD related to sexual assault in civilian populations.

Traditional and Simplified Chinese Abstracts by AsianSTSS


撮要:本研究為一隨機對照臨床實驗,目的是探討認知處理治療(CPT)在與軍役中性創傷(MST)相關的創傷後壓力症(PTSD)及其抑鬱症狀(包括自我報告和醫療判斷)的治療功效,而對象是86名退役軍人(包括73位女性和13位男性) ,分別隨機分配接受12節個人CPT或個人現在聚焦治療(PCT)。盲目評估分別在起點、治療後的即時、兩個月、四個月和六個月的區間。混合效果模型分析顯示群組間有統計上明顯的相互關係 (p=.05, d= -0.85);而治療後,接受CPT的退役軍人有統計上顯著自我報告PTSD症狀減退(但非醫療判斷的PTSD症狀)。在兩組不同的治療中,全部三個基本治療成果評估都隨時間在臨床中及統計上有顯著改進。治療前後的效應為中至高(d=0.30到1.02)而CPT組別有較顯著趨勢。儘管本研究受治療實施的精確度影響,但研究初步証實CPT對有MST的退役軍人中可有效減少自我報告PTSD症狀,而本研究亦充實了CPT在平民中治療與性侵犯有關的PTSD的療效相關文獻。


撮要:本研究为一随机对照临床实验,目的是探讨认知处理治疗(CPT)在与兵役中性创伤(MST)相关的创伤后压力症(PTSD)及其抑郁症状(包括自我报告和医疗判断)的治疗功效,而对象是86名退役军人(包括73位女性和13位男性) ,分别随机分配接受12节个人CPT或个人现在聚焦治疗(PCT)。盲目测评分别在起点、治疗后的实时、两个月、四个月和六个月的区间。混合效果模型分析显示群组间有统计上明显的相互关系 (p=.05, d= -0.85);而治疗后,接受CPT的退役军人有统计上显着自我报告PTSD症状减退(但非医疗判断的PTSD症状)。在两组不同的治疗中,全部三个基本治疗成果测评都随时间在临床中及统计上有显着改进。治疗前后的效应为中至高(d=0.30到1.02)而CPT组别有较显着趋势。尽管本研究受治疗实施的忠诚度影响,但研究初步证实CPT可有效减少有MST的退役军人的自我报告PTSD症状,而本研究亦充实了CPT在平民中治疗与性侵犯有关的PTSD的疗效相关文献。