The effect of childhood sexual assault history on outpatient cognitive processing therapy for military sexual trauma-related posttraumatic stress disorder: A preliminary investigation

2018 ◽  
Vol 35 (1) ◽  
pp. 98-103 ◽  
Author(s):  
Nicholas Holder ◽  
Ryan Holliday ◽  
Alina Surís
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Sexual Assault ◽  
Posttraumatic Stress ◽  
Cognitive Processing ◽  
Sexual Trauma ◽  
Stress Disorder ◽  
Preliminary Investigation ◽  
Cognitive Processing Therapy ◽  
Military Sexual Trauma

Patterns and temporal precedence of symptom change during cognitive processing therapy for military sexual trauma-related posttraumatic stress disorder

2019 ◽  
Vol 47 (5) ◽  
pp. 541-547
Author(s):  
Nicholas Holder ◽  
Ryan Holliday ◽  
Jessica Wiblin ◽  
Alina Surís
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Cognitive Processing ◽  
Sexual Trauma ◽  
Stress Disorder ◽  
Ptsd Symptom ◽  
Cognitive Processing Therapy ◽  
Military Sexual Trauma ◽  
Ptsd Symptoms ◽  
Symptom Criteria

AbstractBackground:Cognitive processing therapy (CPT) is an effective treatment for posttraumatic stress disorder (PTSD), including for veterans with military sexual trauma (MST)-related PTSD. Most CPT research to date has focused on pre- to post-treatment change in total PTSD symptoms; however, PTSD symptom criteria may not change equivalently over the course of treatment. For example, changes in re-experiencing symptoms have been shown to precede changes in other PTSD criteria during other PTSD treatments (i.e. virtual reality exposure therapy, venlafaxine ER). An improved understanding of the mechanism of change in PTSD symptoms during CPT may assist in optimizing treatment.Aims:The purpose of this study was to identify the pattern and temporal precedence of change in PTSD symptom criteria during and after CPT using cross-lagged panel analyses.Method:Data from veterans (n = 32) enrolled in a randomized clinical trial investigating the effectiveness of CPT for MST-related PTSD were utilized for this secondary analysis. Using hierarchical linear modelling, each symptom criterion was entered as a predictor of subsequent change in the other PTSD symptom criteria.Results:All symptom criteria followed a logarithmic pattern of change. Hyperarousal symptoms were found to both predict and temporally precede change in avoidance symptoms, but not re-experiencing symptoms. Re-experiencing and avoidance symptoms did not predict change in other PTSD symptom criteria.Conclusions:These findings provide initial support that targeting and reducing hyperarousal symptoms may be a key component of PTSD intervention with CPT. Additional research is needed to identify factors that predict change in PTSD-related re-experiencing symptoms.

Comparing Veterans with Posttraumatic Stress Disorder Related to Military Sexual Trauma or Other Trauma Types: Baseline Characteristics and Residential Cognitive Processing Therapy Outcomes

2021 ◽  
pp. 088626052110550
Author(s):  
Nicole M. Christ ◽  
Rachel C. Blain ◽  
Nicole D. Pukay-Martin ◽  
Jessica M. Petri ◽  
Kathleen M. Chard
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Cognitive Processing ◽  
Stress Disorder ◽  
Post Treatment ◽  
Cognitive Processing Therapy ◽  
Military Sexual Trauma ◽  
Pre Treatment ◽  
And Gender ◽  
The Impact

The Veterans Health Administration (VHA) has called for improved assessment and intervention for survivors of military sexual trauma (MST) to mitigate deleterious sequalae, including posttraumatic stress disorder (PTSD). Research on the impact of MST-related PTSD (MST-IT) on men is limited, and few studies have examined the differential effects of treatment across genders and MST-IT. Additionally, studies have utilized varying definitions of MST (e.g., sexual assault only vs. including sexual harassment), contributing to disparate outcomes across studies. Utilizing data from 343 veterans seeking residential cognitive processing therapy (CPT) for PTSD in VHA, this study examined the impact of MST-IT and gender on differences in demographic characteristics; pre-treatment severity of PTSD (overall and clusters), depression, and negative posttraumatic cognitions (NPCs); and post-treatment severity of these variables after accounting for pre-treatment severity. Results from 2x2 factorial ANOVAs found no differences in pre-treatment depression or overall PTSD by MST-IT, gender, or their interaction; however, MST-IT survivors presented with greater pre-treatment avoidance, global NPCs, and self-blame. Results from hierarchical linear regression models found only pre-treatment symptom severity significantly predicted post-treatment severity for overall PTSD and all NPCs. These findings suggest veteran survivors of MST-IT appear to benefit similarly from CPT delivered in a VHA residential PTSD program compared to veterans with other index traumas, regardless of gender. Although there were minimal post-treatment differences in PTSD and NPCs by MST-IT status and gender, residual symptoms related to negative cognitions and mood appear to differ across gender and MST-IT status. Specifically, in individuals without MST-IT, post-treatment PTSD symptoms of negative alterations in cognition and mood were higher in men than women. Moreover, women with MST-IT reported more symptoms of depression than both men with MST-IT and women without MST-IT. These findings suggest depressive symptoms decrease through residential PTSD treatment differentially by MST-IT status and gender and warrant further examination.

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