title: Comorbidity in the prediction of Cognitive Processing Therapy treatment outcomes for combat-related posttraumatic stress disorder.
abstract: This paper examines clinical predictors of posttraumatic stress disorder (PTSD) treatment outcomes following Cognitive Processing Therapy (CPT) in Australian military veterans. Fifty nine treatment seeking veterans were enrolled in a randomized controlled trial comparing 12 sessions of CPT (n = 30) with usual treatment (n = 29) at three community-based veterans counseling centers. PTSD and key co-morbidities (depression, anxiety, anger and alcohol use) were measured. Growth curve modeling was used to examine factors which influenced PTSD severity post-treatment. For the CPT condition, baseline anger was the only co-morbidity predictive of change in PTSD severity over time. Participants with higher anger scores showed less of a decrease in PTSD severity over time. Higher anxiety in participants in treatment as usual was significantly associated with better treatment gains. This research suggests that veterans experiencing high levels of anger might benefit from targeted anger reduction strategies to increase the effectiveness of CPT treatment for PTSD.
authors: Australian Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Vic, Australia. Electronic address: d.lloyd@unimelb.edu.au.
authors: D
authors: D
authors: Lloyd
authors: Australian Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Vic, Australia; School of Psychology, Flinders University, SA, Australia.
authors: R D V
authors: RD
authors: Nixon
authors: Australian Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Vic, Australia.
authors: T
authors: T
authors: Varker
authors: Australian Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Vic, Australia.
authors: P
authors: P
authors: Elliott
authors: Veterans and Veterans' Families Counselling Service, Australia.
authors: D
authors: D
authors: Perry
authors: School of Psychology, University of New South Wales, NSW, Australia.
authors: R A
authors: RA
authors: Bryant
authors: Australian Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Vic, Australia.
authors: M
authors: M
authors: Creamer
authors: Australian Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Vic, Australia.
authors: D
authors: D
authors: Forbes
mesh_terms: D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology; D000786:Anger; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology; D001315:Australia / Q000453:epidemiology; D015928:Cognitive Behavioral Therapy; D003130:Combat Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology*
keywords: Cognitive Processing Therapy; PTSD; Predictors; Trauma; Treatment; Veterans