Trauma cognitions are related to symptoms up to 10 years after cognitive behavioral treatment for posttraumatic stress disorder.
Trauma cognitions are related to symptoms up to 10 years after cognitive behavioral treatment for posttraumatic stress disorder.
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DOI：
10.1037/tra0000258
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发表时间：
2017-11
期刊：
影响因子：
--
通讯作者：
Resick PA
中科院分区：
文献类型：
--
作者：
Scher CD;Suvak MK;Resick PA
这项研究考察了1)创伤相关认知与创伤后应激障碍(PTSD)症状之间的关系，以及2)这些关系是否受治疗类型的影响。参与者是171名妇女，他们被随机分为强奸后创伤后应激障碍治疗组。在治疗前、治疗后、3个月、9个月和5-10年的随访中，获得自我报告的创伤相关认知和访谈者评估的创伤后应激障碍症状(即创伤后适应不良信念量表、创伤相关内疚问卷和临床医生应用的创伤后应激障碍量表)。多水平回归分析被用来研究整个研究期间创伤相关认知和创伤后应激障碍症状之间的关系，以及这些关系是否随着治疗类型的不同而不同(即认知加工疗法或长期暴露)。最初的多水平回归分析考察了参与者内部的平均关联，表明对他人的可靠性和可信性、自我价值和判断、伤害威胁和内疚的信念在整个随访过程中与创伤后应激障碍症状有关。生长曲线模型显示，在整个随访过程中，信念变化的模式与之前在同一时间段观察到的创伤后应激障碍症状相似。最后，纳入时间的多层次中介分析进一步表明，信念的改变与后续症状的改变有关。除了一个小的例外，信念和症状之间的关系不受治疗类型的调节。这些数据表明，创伤相关认知是创伤后应激障碍CBT治疗后长期维持治疗成果的潜在机制。此外，这些认知可能是一种共同的、而不是特定的治疗维持机制。
This study examined 1) relationships between trauma-related cognitions and Posttraumatic Stress Disorder (PTSD) symptoms from pre-treatment through a long-term period following cognitive behavioral therapy (CBT) for PTSD and 2) whether these relationships were impacted by treatment type. Participants were 171 women randomized into treatment for PTSD following rape. Measures of self-reported trauma-related cognitions and interviewer-assessed PTSD symptoms (i.e., Posttraumatic Maladaptive Beliefs Scale, Trauma-Related Guilt Inventory, and Clinician-Administered PTSD Scale) were obtained at pre-treatment, post-treatment, and 3-month, 9-month, and 5–10 year follow-ups. Multilevel regression analyses were used to examine relationships between trauma-related cognitions and PTSD symptoms throughout the study period and whether these relationships differed as a function of treatment type (i.e., Cognitive Processing Therapy or Prolonged Exposure). Initial multilevel regression analyses that examined mean within-participant associations suggested that beliefs regarding Reliability and Trustworthiness of Others, Self-Worth and Judgment, Threat of Harm, and Guilt were related to PTSD symptoms throughout follow-up. Growth curve modeling suggested that patterns of belief change throughout follow-up were similar to those previously observed in PTSD symptoms over the same time period. Finally, multilevel mediation analyses that incorporated time further suggested that change in beliefs was related to change in symptoms throughout follow-up. With one minor exception, relationships between beliefs and symptoms were not moderated by treatment type. These data suggest that trauma-related cognitions are a potential mechanism for long-term maintenance of treatment gains following CBT for PTSD. Moreover, these cognitions may be a common, rather than specific, treatment maintenance mechanism.
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影响因子：
4.1
作者：
Ehlers, A;Clark, DM;Fennell, M
通讯作者：
Fennell, M
影响因子：
3.3
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