THE IMPACT OF DISSOCIATION ON PTSD TREATMENT WITH COGNITIVE PROCESSING THERAPY

2012 ◽  
Vol 29 (8) ◽  
pp. 718-730 ◽  
Author(s):  
Patricia A. Resick ◽  
Michael K. Suvak ◽  
Benjamin D. Johnides ◽  
Karen S. Mitchell ◽  
Katherine M. Iverson
Keyword(s):  
Cognitive Processing ◽  
Cognitive Processing Therapy ◽  
Ptsd Treatment ◽  
The Impact

Predictors of change in cognitive processing therapy for veterans in a residential PTSD treatment program

2018 ◽  
Vol 75 (3) ◽  
pp. 364-379 ◽  
Author(s):  
Andrew C. Hale ◽  
Jessica L. Rodriguez ◽  
Theodore P. Wright ◽  
Scott A. Driesenga ◽  
C. Richard Spates
Keyword(s):  
Cognitive Processing ◽  
Treatment Program ◽  
Cognitive Processing Therapy ◽  
Ptsd Treatment ◽  
Predictors Of Change

Examining the Impact of Sexual Revictimization in a Sample of Veterans Undergoing Intensive PTSD Treatment

2020 ◽  
pp. 088626051989733
Author(s):  
Vanessa Tirone ◽  
Dale Smith ◽  
Victoria L. Steigerwald ◽  
Jenna M. Bagley ◽  
Michael Brennan ◽  
...  
Keyword(s):  
Cognitive Processing ◽  
Symptom Severity ◽  
Poor Mental Health ◽  
Treatment Seeking ◽  
Cognitive Processing Therapy ◽  
Depression Symptom ◽  
Symptom Change ◽  
Sexual Revictimization ◽  
The Impact ◽  
Predominately Female

Sexual revictimization refers to exposure to more than one incident of rape and is a known risk factor for poor mental health among civilians. This construct has been understudied among veterans. In addition, although individuals who have experienced revictimization generally have greater symptom severity than those who have experienced one rape, it is unclear whether these differences persist following treatment. This study examined differences between veterans who reported histories of revictimization ( n =111) or a single rape ( n = 45), over the course of a 3-week intensive cognitive processing therapy (CPT)-based treatment program for veterans with posttraumatic stress disorder (PTSD). The sample consisted of predominately female (70.5%) post–9/11 veterans (82.7%). Self-reported PTSD and depression symptom severity were assessed regularly throughout the course of treatment. Controlling for non-interpersonal trauma exposure and whether veterans were seeking treatment for combat or military sexual trauma, sexual revictimization was generally associated with greater pretreatment distress and impairment. However, sexual revictimization did not impact rates of PTSD or depression symptom change over the course of intensive treatment, or overall improvement in these symptoms posttreatment. Our findings suggest that the rates of sexual revictimization are high among treatment-seeking veterans with PTSD. Although veteran survivors of sexual revictimization tend to enter treatment with higher levels of distress and impairment than their singly victimized peers, they are equally as likely to benefit from treatment.

The Impact of Military Status on Cognitive Processing Therapy Outcomes in the Community

2019 ◽  
Vol 32 (2) ◽  
pp. 330-336 ◽  
Author(s):  
Kirsten H. Dillon ◽  
Stefanie T. LoSavio ◽  
Teague R. Henry ◽  
Robert A. Murphy ◽  
Patricia A. Resick
Keyword(s):  
Cognitive Processing ◽  
Cognitive Processing Therapy ◽  
Therapy Outcomes ◽  
The Impact ◽  
Military Status

Comparing PTSD treatment retention among survivors of military sexual trauma utilizing clinical video technology and in-person approaches

2019 ◽  
Vol 26 (7-8) ◽  
pp. 443-451 ◽  
Author(s):  
Lisa M Valentine ◽  
Shannon D Donofry ◽  
Rachel B Broman ◽  
Erin R Smith ◽  
Sheila AM Rauch ◽  
...  
Keyword(s):  
Cognitive Processing ◽  
Sexual Trauma ◽  
Prolonged Exposure ◽  
Cognitive Processing Therapy ◽  
Military Sexual Trauma ◽  
Health Administration ◽  
Video Technology ◽  
Post Traumatic Stress ◽  
Ptsd Treatment ◽  
Delivery Format

Introduction Interventions such as Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) have demonstrated efficacy for the treatment of post-traumatic stress disorder (PTSD) following military sexual trauma (MST). However, MST survivors report a number of logistical and social barriers that impede treatment engagement. In an effort to address these barriers, the Veterans Health Administration offers remote delivery of services using clinical video technology (CVT). Evidence suggests PE and CPT can be delivered effectively via CVT. However, it is unclear whether rates of veteran retention in PTSD treatment for MST delivered remotely is comparable to in-person delivery in standard care. Methods Data were drawn from veterans ( N = 171, 18.1% CVT-enrolled) with PTSD following MST who were engaged in either PE or CPT delivered either via CVT or in person. Veterans chose their preferred treatment modality and delivery format in collaboration with providers. Data were analysed to evaluate full completion (FP) of the protocol and completion of a minimally adequate care (MAC) number of sessions. Results FP treatment completion rates did not differ significantly by treatment delivery format. When evaluating receipt of MAC care, CVT utilizers were significantly less likely to complete. Kaplan–Meier analyses of both survival periods detected significant differences in attrition speed, with the CVT group having higher per-session attrition earlier in treatment. Discussion Disengagement from CVT-delivered treatment generally coincided with early imaginal exposures and writing of trauma narratives. CVT providers may have to take special care to develop rapport and problem-solve anticipated barriers to completion to retain survivors in effective trauma-focused interventions.

scholarly journals Reduced Salience and Enhanced Central Executive Connectivity Following PTSD Treatment

2018 ◽  
Author(s):  
Chadi Abdallah ◽  
Christopher Averill ◽  
Amy Ramage ◽  
Lynnette Averill ◽  
Evelyn Alkin ◽  
...  
Keyword(s):  
Cognitive Processing ◽  
Brain Connectivity ◽  
Secondary Analysis ◽  
Region Of Interest ◽  
Central Executive ◽  
Cognitive Processing Therapy ◽  
Primary Analysis ◽  
Symptom Provocation ◽  
Ptsd Treatment ◽  
Central Executive Network

BACKGROUND: In soldiers with posttraumatic stress disorder (PTSD), symptom provocation was found to induce increased connectivity within the salience network, as measured by functional magnetic resonance imaging (fMRI) and global brain connectivity with global signal regression (GBCr). However, it is unknown whether these GBCr disturbances would normalize following effective PTSD treatment. METHODS: 69 US Army soldiers with (n = 42) and without PTSD (n = 27) completed fMRI at rest and during symptom provocation using subject-specific script imagery. Then, participants with PTSD received 6 weeks (12 sessions) of group cognitive processing therapy (CPT) or present-centered therapy (PCT). At week 8, all participants repeated the fMRI scans. The primary analysis used a region-of-interest approach to determine the effect of treatment on salience GBCr. A secondary analysis was conducted to explore the pattern of GBCr alterations post-treatment in PTSD participants compared to controls. RESULTS: Over the treatment period, PCT significantly reduced salience GBCr (p = .02). Compared to controls, salience GBCr was high pretreatment (PCT, p = .01; CPT, p = .03) and normalized post-PCT (p = .53), but not post-CPT (p = .006). Whole-brain secondary analysis found high GBCr within the central executive network in PTSD participants compared to controls. Post hoc exploratory analyses showed significant increases in executive GBCr following CPT treatment (p = .01). CONCLUSION: The results support previous models relating CPT to central executive network and enhanced cognitive control while unraveling a previously unknown neurobiological mechanism of PCT treatment, demonstrating treatment-specific reduction in salience connectivity during trauma recollection.

Trauma, Dissociation, and Post-traumatic Stress Disorder

2014 ◽  
pp. 363-391
Author(s):  
Terence M. Keane ◽  
Brian P. Marx ◽  
Denise M. Sloan ◽  
Anne DePrince
Keyword(s):  
Cognitive Processing ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Cognitive Processing Therapy ◽  
Post Traumatic Stress ◽  
Assessment And Treatment ◽  
Post Traumatic ◽  
Future Work ◽  
The Impact

Worldwide, post-traumatic stress disorder (PTSD) is among the most common psychological disorders; over the past three decades researchers have made considerable progress in understanding the prevalence of PTSD and its psychological and biological underpinnings, while developing methods for its assessment and treatment. Only included in the diagnostic nomenclature since 1980, the history of PTSD extends as far back as the oldest literature in Western civilization. Homer’s Iliad and Odyssey capture the impact of war on combatants and civilians, as do many of the works of writers and artists across the centuries. The focus of this chapter is on the integration of contemporary work on traumatic stress exposure, psychological dissociation, and the development of PTSD, a disorder characterized by concurrent high levels of anxiety and depression and, in many instances, considerable chronicity and disability. More than 50 randomized controlled treatment outcome studies suggest that cognitive- behavioral treatments are especially effective, and support the use of exposure therapy, stress management therapy, cognitive therapy, cognitive processing therapy, and eye movement desensitization and reprocessing in treating PTSD. All these approaches constitute key evidence-based psychological treatments for PTSD. Future work will determine which treatments used by which therapists are best for patients with specific symptoms and concomitant conditions.

scholarly journals Predictors of differential PTSD treatment outcomes between veteran and civilian women after cognitive processing therapy.

2018 ◽  
Vol 10 (2) ◽  
pp. 173-182 ◽  
Author(s):  
Robyn L. Gobin ◽  
Margaret-Anne Mackintosh ◽  
Emy Willis ◽  
Carolyn B. Allard ◽  
Karen Kloezeman ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Cognitive Processing ◽  
Cognitive Processing Therapy ◽  
Ptsd Treatment ◽  
Civilian Women

A Critical Review of Negative Affect and the Application of CBT for PTSD

2016 ◽  
Vol 19 (2) ◽  
pp. 176-194 ◽  
Author(s):  
Wilson J. Brown ◽  
Daniel Dewey ◽  
Brian E. Bunnell ◽  
Stephen J. Boyd ◽  
Allison K. Wilkerson ◽  
...  
Keyword(s):  
Negative Affect ◽  
Cognitive Processing ◽  
Prolonged Exposure ◽  
Cognitive Processing Therapy ◽  
Initial Information ◽  
Emotional Reasoning ◽  
Negative Valence ◽  
Potential Efficacy ◽  
Behavioral Therapies ◽  
The Impact

Forms of cognitive and behavioral therapies (CBTs), including prolonged exposure and cognitive processing therapy, have been empirically validated as efficacious treatments for posttraumatic stress disorder (PTSD). However, the assumption that PTSD develops from dysregulated fear circuitry possesses limitations that detract from the potential efficacy of CBT approaches. An analysis of these limitations may provide insight into improvements to the CBT approach to PTSD, beginning with an examination of negative affect as an essential component to the conceptualization of PTSD and a barrier to the implementation of CBT for PTSD. As such, the literature regarding the impact of negative affect on aspects of cognition (i.e., attention, processing, memory, and emotion regulation) necessary for the successful application of CBT was systematically reviewed. Several literature databases were explored (e.g., PsychINFO and PubMed), resulting in 25 articles that met criteria for inclusion. Results of the review indicated that high negative affect generally disrupts cognitive processes, resulting in a narrowed focus on stimuli of a negative valence, increased rumination of negative autobiographical memories, inflexible preservation of initial information, difficulty considering counterfactuals, reliance on emotional reasoning, and misinterpretation of neutral or ambiguous events as negative, among others. With the aim to improve treatment efficacy of CBT for PTSD, suggestions to incorporate negative affect into research and clinical contexts are discussed.

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