Qualitative examination of cognitive change during PTSD treatment for active duty service members

Abstract

The current study investigated changes in service members' cognitions over the course of Cognitive Processing Therapy (CPT) for posttraumatic stress disorder (PTSD). Sixty-three active duty service members with PTSD were drawn from 2 randomized controlled trials of CPT-Cognitive Only (CPT-C). Participants wrote an impact statement about the meaning of their index trauma at the beginning and again at the end of therapy. Clauses from each impact statement were qualitatively coded into three categories for analysis: assimilation, accommodation, and overaccommodation. The PTSD Checklist, Posttraumatic Symptom Scale-Interview Version, and the Beck Depression Inventory-II were administered at baseline and posttreatment. Repeated measures analyses documented a significant decrease in the percentage of assimilated or overaccommodated statements and an increase in the percentage of accommodated statements from the beginning to the end of treatment. Changes in accommodated statements over the course of treatment were negatively associated with PTSD and depression symptom severity, while statements indicative of overaccommodation were positively associated with both PTSD and depression symptom severity. Treatment responders had fewer overaccommodated and more accommodated statements. Findings suggest that CPT-C changes cognitions over the course of treatment. Methodological limitations and the lack of association between assimilation and PTSD symptom severity are further discussed.

Young people’s trauma‐related cognitions before and after cognitive processing therapy for post‐traumatic stress disorder

“…In this study, even though our sample was predominantly female, statements were closest in length to those from the Dondanville et al. (2016) study. In fact, at post‐CPT statements from our sample were the shortest.…”

“…Dondanville et al. (2016) analysed impact statements from 63 service members who were predominantly male and had experienced military trauma. This sample received CPT, partly in an individual and partly in a group setting.…”

A model comparison approach to trauma-related guilt as a mediator of the relationship between PTSD symptoms and suicidal ideation among veterans

“…This finding is consistent with existing PTSD treatment literature. There is evidence that some trauma-focused treatments (e.g., Cognitive Processing Therapy; Resick, Monson, & Chard, 2017) that directly target erroneous guilt cognitions effectively reduce both trauma-related guilt (e.g., Dondanville et al, 2016) and suicidal ideation (Bryan et al, 2016). …”

Making meaning of cancer: A qualitative analysis of oral-digestive cancer survivors’ reflections

“…In this article, we will use the framework presented in Figure 1. We distinguish between (1) searching for meaning-the "why" that may instigate meaning-making processes (Lee, 2008); (2) meaning-making processes-cognitive and emotional processing of meanings and beliefs-the "how" (Dondanville et al, 2016); from (3) finding meaning-the beliefs and cognitions or "meanings made"-the "what" (Park, 2010). In the following, we briefly set forth these terms as we will use them in presenting our results.…”