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Comparing Response to Cognitive Processing Therapy in Military Veterans With Subthreshold and Threshold Posttraumatic Stress Disorder


  • The authors would like to sincerely thank all of the staff at the Trauma Recovery Center, particularly Lindsey Davidson, BA, and Misty Wolfe, MPH, for their assistance with data management. The content of this manuscript does not reflect the views of the United States Government or Department of Veterans Affairs.


Research suggests that subthreshold posttraumatic stress disorder (PTSD) symptomatology is associated with increased risk for psychological and functional impairment, including increased risk for suicidal ideation. However, it does not appear that any studies to date have investigated whether subthreshold PTSD can effectively be treated with evidence-based, trauma-focused treatment. Accordingly, we tested response to cognitive processing therapy (CPT) in 2 groups of military veterans receiving care at a VA outpatient specialty clinic, 1 with subthreshold PTSD at pretreatment (n = 51) and the other with full, diagnostic PTSD (n = 483). Multilevel analysis revealed that both groups experienced a significant decrease in PTSD symptoms over the course of therapy (the full and subthreshold PTSD groups experienced an average decrease of 1.79 and 1.52 points, respectively, on the PTSD Checklist with each increment of time, which was coded from 0 at pretreatment to 13 at posttreatment). After controlling for pretreatment symptom severity, a between-groups difference was not found. These results suggest that CPT is an effective form of treatment among military veterans, and that its effectiveness does not differ between subthreshold and threshold groups.

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撮要: 研究指出亞創傷後壓力症(PTSD)的症狀學與心理及功能障礙方面的較高風險有關連,其中包括自殺念頭的風險增高。但是沒有研究於亞創傷後壓力症實證「創傷為本」治療會否有效。我們在一個VA專科門診中選取兩組求診退役軍人(一組患有亞創傷後壓力症(n = 51)而另一組則為PTSD(n = 483))以評估認知處理療法(CPT)的效果。多層次分析剖析治療完成後兩組人有顯著PTSD症狀減少;隨時間值增多準PTSD和亞PTSD分別在PTSD清單有平均1.79及1.52分下調(由治療前的0到治療後13的時間值)。對照治療前症狀嚴重度後, 組別之間未有差別。結果顯示CPT在退役軍人中有效治療PTSD,而其效果在亞創傷後壓力症和創傷後壓力症組別之間未有差異。


撮要: 研究指出亚创伤后压力症(PTSD)的症状学与心理及功能障碍方面的较高风险有联系,其中包括自杀念头的风险增高。但是没有研究于亚创伤后压力症实证「创伤为本」治疗会否有效。我们在一个VA专科门诊中选取两组求诊退役军人(一组患有亚创伤后压力症(n = 51)而另一组则为PTSD(n = 483))以评估认知处理疗法(CPT)的效果。多层次分析剖析治疗完成后两组人有显着PTSD症状减少;随时间值增多准PTSD和亚PTSD分别在PTSD列表有平均1.79及1.52分下调(由治疗前的0到治疗后13的时间值)。对照治疗前症状严重度后, 组别之间未有差别。结果显示CPT在退役军人中有效治疗PTSD,而其效果在亚创伤后压力症和创伤后压力症组别之间未有差异。

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