title: Rape survivors' trauma-related beliefs before and after Cognitive processing therapy: associations with PTSD and depression symptoms.
abstract: This study examined whether cognitive distortions (i.e., assimilated and overaccommodated thoughts) and realistic (i.e., accommodated) thoughts assessed from impact statements written 5-10 years after completing cognitive processing therapy (CPT) accurately predicted posttreatment maintenance or decline in treatment gains during the same period. The sample included 50 women diagnosed with posttraumatic stress disorder (PTSD) secondary to rape who participated in a randomized clinical trial of CPT for PTSD. Cognitions were assessed via coding and analyses of participants' written impact statements at three time points: beginning of treatment, end of treatment, and at 5-10 years follow-up. Primary mental health outcomes were symptoms of PTSD (Clinician-Administered PTSD Scale) and depression (Beck Depression Inventory). Changes in trauma-related beliefs between the end of treatment and long-term follow-up were associated with concomitant changes in PTSD and depression symptoms (effect sizes ranging from r = .35-.54). Declines in accommodated thinking and increases in overaccommodated thinking were associated with elevations in symptomatology. Improvement in accommodated thinking and declines in overaccommodated thinking were associated with lower PTSD and depression symptoms during this same time period. Findings provided support for the role of changes in accommodated and overaccommodated thinking being associated with level of PTSD and depression many years after participating in CPT.
authors.affiliation: National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA. Electronic address: Katherine.Iverson@va.gov.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Iverson
authors.affiliation: National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: King
authors.affiliation: Department of Psychology, The University of Tulsa, Tulsa, OK, USA.
authors.forename: Katherine C
authors.initials: KC
authors.lastname: Cunningham
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Resick
mesh_terms: D000328:Adult; D003071:Cognition; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D011902:Rape / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*; D017741:Survivors / Q000523:psychology*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cognitive distortions; Cognitive-behavioral therapy; Depression; Mixed-methods; Posttraumatic stress disorder