title: Changes in negative cognitions mediate PTSD symptom reductions during client-centered therapy and prolonged exposure for adolescents.
abstract: OBJECTIVE
  To assess whether changes in negative trauma-related cognitions play an important role in reducing symptoms of posttraumatic stress disorder (PTSD) and depression during prolonged exposure therapy for adolescents (PE-A).
  
  
  METHODS
  Secondary analysis of data from a randomized controlled trial comparing PE-A with client-centered therapy (CCT) for PTSD. Participants were 61 adolescent female sexual assault survivors ages 13-18 who received 8-14 weekly sessions of PE-A or CCT at a community rape crisis center. PTSD severity was assessed at baseline, mid-treatment, post-treatment, and 3-months post-treatment. Participants also completed self-report measures of negative posttraumatic cognitions and depressive symptoms at the same assessment points.
  
  
  RESULTS
  Cross lag panel mediation analyses showed that change in negative trauma-related cognitions mediated change in PTSD symptoms and depressive symptoms whereas change in PTSD and depressive symptoms did not mediate change in negative cognitions.
  
  
  CONCLUSIONS
  Our findings support EPT and suggest that change in negative trauma-related cognitions is a mechanism of both PE-A and CCT.
authors: Department of Psychiatry, University of Pennsylvania, USA. Electronic address: mcleanca@mail.med.upenn.edu.
authors: Carmen P
authors: CP
authors: McLean
authors: Department of Psychiatry, University of Pennsylvania, USA.
authors: Rebecca
authors: R
authors: Yeh
authors: Department of Psychology, Southern Methodist University, USA.
authors: David
authors: D
authors: Rosenfield
authors: Department of Psychiatry, University of Pennsylvania, USA.
authors: Edna B
authors: EB
authors: Foa
mesh_terms: D000293:Adolescent; D003071:Cognition / Q000502:physiology; D003863:Depression / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D007171:Implosive Therapy; D009341:Negativism; D009629:Person-Centered Psychotherapy / Q000379:methods*; D011902:Rape / Q000523:psychology* / Q000534:rehabilitation*; D012742:Sex Offenses / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*; D017741:Survivors; D016896:Treatment Outcome
keywords: Adolescents; Mechanisms; Negative cognitions; Post-traumatic stress; Prolonged exposure