Changes in cognitive processes and coping strategies precede changes in symptoms during cognitive therapy for posttraumatic stress disorder

Milan Wiedemann; Magdalena Janecka; Jennifer Wild; Emma Warnock-Parkes; Richard Stott; Nick Grey; David M. Clark; Anke Ehlers

doi:10.1016/j.brat.2023.104407

Changes in cognitive processes and coping strategies precede changes in symptoms during cognitive therapy for posttraumatic stress disorder

Milan Wiedemann, Magdalena Janecka, Jennifer Wild, Emma Warnock-Parkes, Richard Stott, Nick Grey, David M. Clark, Anke Ehlers

Research output: Contribution to journal › Article › peer-review

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Abstract

Theories of posttraumatic stress disorder (PTSD) highlight the role of cognitive and behavioral factors in its development, maintenance, and treatment. This study investigated the relationship between changes in factors specified in Ehlers and Clark's (2000) model of PTSD and PTSD symptom change in 217 patients with PTSD who were treated with cognitive therapy for PTSD (CT-PTSD) in routine clinical care. Bivariate latent change score models (LCSM) of session-by-session changes in self-report measures showed that changes in PTSD symptoms were preceded by changes in negative appraisals, flashback characteristics of unwanted memories, safety behaviours, and unhelpful responses to intrusions, but not vice versa. For changes in trauma memory disorganization and PTSD symptoms we found a bidirectional association. This study provides evidence that cognitive and behavioral processes proposed in theoretical models of PTSD play a key role in driving symptom improvement during CT-PTSD.

Original language	English
Article number	104407
Journal	Behaviour Research and Therapy
Volume	169
DOIs	https://doi.org/10.1016/j.brat.2023.104407
State	Published - Oct 2023

Keywords

Appraisals
Change processes
Cognitive therapy
Coping
Memory
PTSD
Structural equation model

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10.1016/j.brat.2023.104407

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title = "Changes in cognitive processes and coping strategies precede changes in symptoms during cognitive therapy for posttraumatic stress disorder",

abstract = "Theories of posttraumatic stress disorder (PTSD) highlight the role of cognitive and behavioral factors in its development, maintenance, and treatment. This study investigated the relationship between changes in factors specified in Ehlers and Clark's (2000) model of PTSD and PTSD symptom change in 217 patients with PTSD who were treated with cognitive therapy for PTSD (CT-PTSD) in routine clinical care. Bivariate latent change score models (LCSM) of session-by-session changes in self-report measures showed that changes in PTSD symptoms were preceded by changes in negative appraisals, flashback characteristics of unwanted memories, safety behaviours, and unhelpful responses to intrusions, but not vice versa. For changes in trauma memory disorganization and PTSD symptoms we found a bidirectional association. This study provides evidence that cognitive and behavioral processes proposed in theoretical models of PTSD play a key role in driving symptom improvement during CT-PTSD.",

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author = "Milan Wiedemann and Magdalena Janecka and Jennifer Wild and Emma Warnock-Parkes and Richard Stott and Nick Grey and Clark, {David M.} and Anke Ehlers",

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AU - Wiedemann, Milan

AU - Janecka, Magdalena

AU - Wild, Jennifer

AU - Warnock-Parkes, Emma

AU - Stott, Richard

AU - Grey, Nick

AU - Clark, David M.

AU - Ehlers, Anke

PY - 2023/10

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KW - Change processes

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Changes in cognitive processes and coping strategies precede changes in symptoms during cognitive therapy for posttraumatic stress disorder

Abstract

Keywords

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