Changes in Coping and Negative Cognitions as Mechanisms of Change in Online Treatment for Rape‐Related Posttraumatic Stress Disorder

Abstract

Cognitive behavioral therapy (CBT)-based interventions, including those administered via telepsychology, represent efficacious posttraumatic stress disorder (PTSD) treatments. Despite demonstrated efficacy, limited research has examined mechanisms of change for CBT. We examined trauma-related cognitions and coping as treatment mechanisms among 46 women who completed a randomized clinical trial of a CBT-based, telepsychology-delivered interactive program for rape survivors. The results indicated that both the interactive program, d = 1.5, and the active control condition, a psychoeducational website, d = 1.4, resulted in large reductions in posttest PTSD symptoms. Analysis of residual gain scores showed that reductions in the three types of assessed trauma-related cognitions were strongly related to reductions in PTSD symptoms among women assigned to the interactive program, rs = .60-.79, but only weakly related to symptom reduction among those assigned to active control, rs = .06-.31. The results also suggest that increases in trauma-related approach coping were weakly related to reductions in PTSD symptoms among participants in the interactive program, rs = −.16 and −.17, but, conversely, decreases in trauma-related approach coping were weakly related to reductions in PTSD symptoms among those in the active control group, rs = .07 and .28. Reductions in avoidance coping were modestly related to reductions in PTSD symptoms among women in the interactive program, rs = .38 and .38, but unrelated to changes in PTSD symptoms among those assigned to the active control, rs = .03 and .05. Implications for future work examining mechanisms of change for PTSD treatments are discussed.

Transformación digital de la atención psicológica: estado actual de la telepsicología en Colombia

“…En este caso, se contó con dos grupos, uno acompañado de un terapeuta y uno redirigido a la web psicoeducativa. El programa interactivo asistido por psicoterapeuta mostró un fortalecimiento de los procesos de afrontamiento de las pacientes y una reducción de cogniciones y síntomas asociados al trauma al final del proceso (Littleton & Grills, 2019).…”

Don’t fade on me: Coping, instrumental support, and posttraumatic growth in the year after a catastrophic hurricane-flood.

“…Each difference score was calculated by subtracting the Time 2 measurement from the Time 1 measurement. In contrast, residual gain scores were calculated using the procedure outlined previously in the literature, addressing any potential over- or underestimation of change that might be related to use of raw difference scores (Littleton & Grills, 2019).…”

EHealth for Sexual Assault: A Systematic Scoping Review

“…Of the 29 studies that investigated if eHealth interventions reduce the negative impacts of sexual assault (and in particular PTSD), at least some positive impacts of eHealth were noted in all studies (Acierno et al, 2021; Banducci, 2021; Bomyea et al, 2015; Creech, Pulverman, Kahler, et al, 2021; Creech, Pulverman, Shin, et al, 2021; Gilmore et al, 2021; Gilmore, Walsh, et al, 2019; Gray et al, 2015; Hassija & Gray, 2011; Jaffe et al, 2021; Johnson, 2020; Lange & Ruwaard, 2010; Lee & Cha, 2021; Littleton & Grills, 2019; Littleton et al, 2012, 2016; Lopez et al, 2021; Loucks et al, 2019; Miller et al, 2015; Norman et al, 2020; Resnick et al, 2012; Sitz et al, 2021; Stappenbeck et al, 2021; Steinmetz & Gray, 2017; Walsh et al, 2017, 2020, 2021; Weiss et al, 2018; Zheng & Gray, 2014). To provide an example, 6–12 virtual reality exposure sessions led to significant reductions in PTSD and depression symptoms in 15 MST survivors (Loucks et al, 2019).…”