title: Fear of Losing Emotional Control Is Associated With Cognitive Processing Therapy Outcomes in U.S. Veterans of Afghanistan and Iraq.
abstract: Evidence-based treatments for posttraumatic stress disorder (PTSD) can reduce symptoms and improve veterans' psychological health. Unfortunately, many veterans leave treatment before receiving maximum benefit. Fear of emotions is related to severity of PTSD, and changes in fear of emotions are correlated with changes in PTSD symptoms. This study built upon the literature linking greater fear of emotions to PTSD severity by examining whether pretreatment fear of emotions, measured by the Affect Control Scale, was associated with completion of cognitive processing therapy (CPT) and severity of posttreatment PTSD in a sample of 89 U.S. veterans who had served in Afghanistan and Iraq. About 60% of veterans completed 10 or more therapy sessions. A logistic regression on 51 of the 89 subjects that more fear of anxiety at pretreatment was associated with decreased likelihood of completing treatment, OR = 0.93, 95% CI [0.87, 1.00]. Of those veterans who completed treatment, higher fear of anger at pretreatment was negatively related to severity of PTSD posttreatment (β = -.29, p = .037), in a model with the other predictors. Assessing veterans for fear of anxiety and anger before CPT and teaching emotion regulation skills to those in need may reduce treatment dropout.
authors.affiliation: Mental Health Care Line, Michael E. DeBakey Veterans Affairs (VA) Medical Center, Houston, Texas, USA.|Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA.|South Central Mental Illness, Research, Education, and Clinical Center (MIRECC), Houston, Texas, USA.
authors.forename: Shannon R
authors.initials: SR
authors.lastname: Miles
authors.affiliation: Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA.|Mental Health Service Line, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA.
authors.forename: Tracey L
authors.initials: TL
authors.lastname: Smith
authors.affiliation: Mental Health Service Line, Edward Hines Jr. VA Hospital, Hines, Illinois, USA.
authors.forename: Kelly P
authors.initials: KP
authors.lastname: Maieritsch
authors.affiliation: Department of Psychiatry, University of Wisconsin Hospitals and Clinics, Madison, Wisconsin, USA.|Mental Health Service Line, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA.
authors.forename: Eileen P
authors.initials: EP
authors.lastname: Ahearn
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D016015:Logistic Models; D008297:Male; D010352:Patient Dropouts / Q000523:psychology* / Q000706:statistics & numerical data; D000068356:Self-Control / Q000523:psychology*; D017678:Sex Distribution; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D014481:United States; D014728:Veterans / Q000523:psychology