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17-01-2024 | Original Article

Exploring the Associations of Emotion Regulation and Trait Resilience with the Efficacy of Cognitive Processing Therapy for Active Duty Military Personnel with PTSD

Auteurs: Craig P. Polizzi, Jennifer Schuster Wachen, Casey L. Straud, Jim Mintz, Allison L. Baier, Katherine A. Dondanville, Stacey Young-McCaughan, Brett T. Litz, Jeffrey S. Yarvis, Alan L. Peterson, Patricia A. Resick, for the STRONG STAR Consortium

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 4/2024

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Abstract

Background

Military personnel who complete cognitive processing therapy (CPT) can still experience residual symptoms of posttraumatic stress disorder (PTSD). Gaining a deeper understanding of the characteristics that influence response to CPT may increase the likelihood of treatment success. Emotion regulation and trait resilience are associated with PTSD severity and may influence treatment response in active duty service members with PTSD.

Methods

This secondary analysis explored the association among reports of baseline emotion regulation (Cognitive Emotion Regulation Questionnaire-Short Form) and trait resilience (Response to Stressful Experiences Scale) with PTSD severity reductions in a sample of active duty service members (N = 268) who participated in a clinical trial that compared group-delivered and individual CPT. Population averaged models were utilized to examine if baseline predictors were related to change in PTSD severity from pre- to posttreatment.

Results

Trait resilience predicted PTSD severity changes such that participants who reported less trait resilience at baseline demonstrated greater PTSD severity reductions over a course of CPT. There was also a main effect of adaptive emotion regulation on PTSD severity. Post-hoc correlation analyses revealed that baseline adaptive emotion regulation was positively associated with PTSD severity at pre- and posttreatment.

Conclusions

Findings imply that service members with lower trait resilience may particularly benefit from CPT. Whether trait resilience moderates PTSD outcomes specific to CPT will require a trial with an alternative comparison treatment arm.

Clinical Trial Registration

ClinicalTrials.gov identifier: NCT02173561 (6/25/2014)
Literatuur
go back to reference Alpert, E., Carpenter, J. K., Smith, B. N., Woolley, M. G., Raterman, C., Farmer, C. C., Kehle-Forbes, S. M., & Galovski, T. E. (2023). Leveraging observational data to identify in-session patient and therapist predictors of cognitive processing therapy response and completion. Journal of Traumatic Stress, 36(2), 397–408. Alpert, E., Carpenter, J. K., Smith, B. N., Woolley, M. G., Raterman, C., Farmer, C. C., Kehle-Forbes, S. M., & Galovski, T. E. (2023). Leveraging observational data to identify in-session patient and therapist predictors of cognitive processing therapy response and completion. Journal of Traumatic Stress, 36(2), 397–408.
go back to reference American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders. American Psychiatric Association. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders. American Psychiatric Association.
go back to reference Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Lawrence Erlbaum Associates. Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Lawrence Erlbaum Associates.
go back to reference Cusack, K., Jonas, D. E., Forneris, C. A., Wines, C., Sonis, J., Middleton, J. C., Feltner, C., Brownley, K. A., Olmsted, K. R., Greenblatt, A., Weil, A., & Gaynes, B. N. (2016). Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis. Clinical Psychology Review,43, 128–141. https://doi.org/10.1016/j.cpr.2015.10.003CrossRefPubMed Cusack, K., Jonas, D. E., Forneris, C. A., Wines, C., Sonis, J., Middleton, J. C., Feltner, C., Brownley, K. A., Olmsted, K. R., Greenblatt, A., Weil, A., & Gaynes, B. N. (2016). Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis. Clinical Psychology Review,43, 128–141. https://​doi.​org/​10.​1016/​j.​cpr.​2015.​10.​003CrossRefPubMed
go back to reference DeViva, J. C., Sheerin, C. M., Southwick, S. M., Roy, A. M., Pietrzak, R. H., & Harpaz-Rotem, I. (2016). Correlates of VA mental health treatment utilization among OEF/OIF/OND veterans: Resilience, stigma, social support, personality, and beliefs about treatment. Psychological Trauma: Theory Research Practice and Policy,8(3), 310–318. https://doi.org/10.1037/tra0000075CrossRefPubMed DeViva, J. C., Sheerin, C. M., Southwick, S. M., Roy, A. M., Pietrzak, R. H., & Harpaz-Rotem, I. (2016). Correlates of VA mental health treatment utilization among OEF/OIF/OND veterans: Resilience, stigma, social support, personality, and beliefs about treatment. Psychological Trauma: Theory Research Practice and Policy,8(3), 310–318. https://​doi.​org/​10.​1037/​tra0000075CrossRefPubMed
go back to reference Dillon, K. H., Hale, W. J., LoSavio, S. T., Wachen, J. S., Pruiksma, K. E., Yarvis, J. S., Mintz, J., Litz, B. T., Peterson, A. L., Resick, P. A., on behalf of the STRONG STAR Consortium. (2020). Weekly changes in blame and PTSD among active-duty military personnel receiving cognitive processing therapy. Behavior Therapy,51(3), 386–400. https://doi.org/10.1016/j.beth.2019.06.008CrossRefPubMed Dillon, K. H., Hale, W. J., LoSavio, S. T., Wachen, J. S., Pruiksma, K. E., Yarvis, J. S., Mintz, J., Litz, B. T., Peterson, A. L., Resick, P. A., on behalf of the STRONG STAR Consortium. (2020). Weekly changes in blame and PTSD among active-duty military personnel receiving cognitive processing therapy. Behavior Therapy,51(3), 386–400. https://​doi.​org/​10.​1016/​j.​beth.​2019.​06.​008CrossRefPubMed
go back to reference Feliu-Soler, A., Reche-Camba, E., Borràs, X., Pérez-Aranda, A., Andrés-Rodríguez, L., Peñarrubia-María, M. T., Navarro-Gil, M., García-Campayo, J., Bellón, J. A., & Luciano, J. V. (2017). Psychometric properties of the cognitive emotion regulation questionnaire (CERQ) in patients with fibromyalgia syndrome. Frontiers in Psychology,8, Article2075. https://doi.org/10.3389/fpsyg.2017.02075CrossRef Feliu-Soler, A., Reche-Camba, E., Borràs, X., Pérez-Aranda, A., Andrés-Rodríguez, L., Peñarrubia-María, M. T., Navarro-Gil, M., García-Campayo, J., Bellón, J. A., & Luciano, J. V. (2017). Psychometric properties of the cognitive emotion regulation questionnaire (CERQ) in patients with fibromyalgia syndrome. Frontiers in Psychology,8, Article2075. https://​doi.​org/​10.​3389/​fpsyg.​2017.​02075CrossRef
go back to reference Georgoulas-Sherry, V., & Kelly, D. (2019). Resilience, grit, and hardiness: Determining the relationships amongst these constructs through structural equation modeling techniques. Journal of Positive Psychology and Wellbeing,3(2), 165–178. Georgoulas-Sherry, V., & Kelly, D. (2019). Resilience, grit, and hardiness: Determining the relationships amongst these constructs through structural equation modeling techniques. Journal of Positive Psychology and Wellbeing,3(2), 165–178.
go back to reference Kaczkurkin, A. N., Zang, Y., Gay, N. G., Peterson, A. L., Yarvis, J. S., Borah, E. V., Dondanville, K. A., Hembree, E. A., Litz, B. T., Mintz, J., Young-McCaughan, S., Foa, E. B., STRONG STAR Consortium. (2017). Cognitive emotion regulation strategies associated with the DSM-5 posttraumatic stress disorder criteria. Journal of Traumatic Stress,30(4), 343–350. https://doi.org/10.1002/jts.22202CrossRefPubMed Kaczkurkin, A. N., Zang, Y., Gay, N. G., Peterson, A. L., Yarvis, J. S., Borah, E. V., Dondanville, K. A., Hembree, E. A., Litz, B. T., Mintz, J., Young-McCaughan, S., Foa, E. B., STRONG STAR Consortium. (2017). Cognitive emotion regulation strategies associated with the DSM-5 posttraumatic stress disorder criteria. Journal of Traumatic Stress,30(4), 343–350. https://​doi.​org/​10.​1002/​jts.​22202CrossRefPubMed
go back to reference Kazdin, A. E. (2014). Moderators, mediators and mechanisms of change in psychotherapy. In W. Lutz & S. Knox (Eds.), Quantitative and qualitative methods in psychotherapy research (pp. 87–101). Routledge.CrossRef Kazdin, A. E. (2014). Moderators, mediators and mechanisms of change in psychotherapy. In W. Lutz & S. Knox (Eds.), Quantitative and qualitative methods in psychotherapy research (pp. 87–101). Routledge.CrossRef
go back to reference Klemanski, D. H., Mennin, D. S., Borelli, J. L., Morrissey, P. M., & Aikins, D. E. (2012). Emotion-related regulatory difficulties contribute to negative psychological outcomes in active‐duty Iraq War soldiers with and without posttraumatic stress disorder. Depression and Anxiety,29(7), 621–628. https://doi.org/10.1002/da.21914CrossRefPubMed Klemanski, D. H., Mennin, D. S., Borelli, J. L., Morrissey, P. M., & Aikins, D. E. (2012). Emotion-related regulatory difficulties contribute to negative psychological outcomes in active‐duty Iraq War soldiers with and without posttraumatic stress disorder. Depression and Anxiety,29(7), 621–628. https://​doi.​org/​10.​1002/​da.​21914CrossRefPubMed
go back to reference Lee, D. J., Witte, T. K., Weathers, F. W., & Davis, M. T. (2015). Emotion regulation strategy use and posttraumatic stress disorder: Associations between multiple strategies and specific symptom clusters. Journal of Psychopathology and Behavioral Assessment,37(3), 533–544. https://doi.org/10.1007/s10862-014-9477-3CrossRef Lee, D. J., Witte, T. K., Weathers, F. W., & Davis, M. T. (2015). Emotion regulation strategy use and posttraumatic stress disorder: Associations between multiple strategies and specific symptom clusters. Journal of Psychopathology and Behavioral Assessment,37(3), 533–544. https://​doi.​org/​10.​1007/​s10862-014-9477-3CrossRef
go back to reference Resick, P. A., Monson, C. M., & Chard, K. M. (2016). Cognitive processing therapy for PTSD: A comprehensive manual. The Guilford Press. Resick, P. A., Monson, C. M., & Chard, K. M. (2016). Cognitive processing therapy for PTSD: A comprehensive manual. The Guilford Press.
go back to reference Resick, P. A., Wachen, J. S., Dondanville, K. A., Pruiksma, K. E., Yarvis, J. S., Peterson, A. L., Mintz, J., the STRONG STAR Consortium. (2017). Effect of group vs individual cognitive processing therapy in active-duty military seeking treatment for posttraumatic stress disorder: A randomized clinical trial. JAMA Psychiatry,74(1), 28–36. https://doi.org/10.1001/jamapsychiatry.2016.2729CrossRefPubMed Resick, P. A., Wachen, J. S., Dondanville, K. A., Pruiksma, K. E., Yarvis, J. S., Peterson, A. L., Mintz, J., the STRONG STAR Consortium. (2017). Effect of group vs individual cognitive processing therapy in active-duty military seeking treatment for posttraumatic stress disorder: A randomized clinical trial. JAMA Psychiatry,74(1), 28–36. https://​doi.​org/​10.​1001/​jamapsychiatry.​2016.​2729CrossRefPubMed
go back to reference Resick, P. A., Wachen, J. S., Mintz, J., Young-McCaughan, S., Roache, J. D., Borah, A. M., Borah, E. V., Dondanville, K. A., Hembree, E. A., Litz, B. T., Peterson, A. L., on behalf of the STRONG STAR Consortium. (2015). A randomized clinical trial of group cognitive processing therapy compared with group present-centered therapy for PTSD among active duty military personnel. Journal of Consulting and Clinical Psychology,83(6), 1058–1068. https://doi.org/10.1037/ccp0000016CrossRefPubMed Resick, P. A., Wachen, J. S., Mintz, J., Young-McCaughan, S., Roache, J. D., Borah, A. M., Borah, E. V., Dondanville, K. A., Hembree, E. A., Litz, B. T., Peterson, A. L., on behalf of the STRONG STAR Consortium. (2015). A randomized clinical trial of group cognitive processing therapy compared with group present-centered therapy for PTSD among active duty military personnel. Journal of Consulting and Clinical Psychology,83(6), 1058–1068. https://​doi.​org/​10.​1037/​ccp0000016CrossRefPubMed
go back to reference Rice, V., & Liu, B. (2016). Personal resilience and coping part 2: Identifying resilience and coping among U.S. military service members and veterans with implications for work. Work: Journal of Prevention Assessment & Rehabilitation,54(2), 335–350. https://doi.org/10.3233/WOR-162301CrossRef Rice, V., & Liu, B. (2016). Personal resilience and coping part 2: Identifying resilience and coping among U.S. military service members and veterans with implications for work. Work: Journal of Prevention Assessment & Rehabilitation,54(2), 335–350. https://​doi.​org/​10.​3233/​WOR-162301CrossRef
go back to reference Vyas, K. J., Fesperman, S. F., Nebeker, B. J., Gerard, S. K., Boyd, N. D., Delaney, E. M., Webb-Murphy, J. A., & Johnston, S. L. (2016). Preventing PTSD and depression and reducing health care costs in the military: A call for building resilience among service members. Military Medicine,181(10), 1240–1247. https://doi.org/10.7205/MILMED-D-15-00585CrossRefPubMed Vyas, K. J., Fesperman, S. F., Nebeker, B. J., Gerard, S. K., Boyd, N. D., Delaney, E. M., Webb-Murphy, J. A., & Johnston, S. L. (2016). Preventing PTSD and depression and reducing health care costs in the military: A call for building resilience among service members. Military Medicine,181(10), 1240–1247. https://​doi.​org/​10.​7205/​MILMED-D-15-00585CrossRefPubMed
go back to reference Weathers, F. W., Litz, B. T., Herman, D. S., Huska, J. A., & Keane, T. M. (1993). The PTSD checklist (PCL): Reliability, validity, and diagnostic utility [Paper presentation]. Annual convention of the International Society for Traumatic Stress Studies. Weathers, F. W., Litz, B. T., Herman, D. S., Huska, J. A., & Keane, T. M. (1993). The PTSD checklist (PCL): Reliability, validity, and diagnostic utility [Paper presentation]. Annual convention of the International Society for Traumatic Stress Studies.
go back to reference Wortmann, J. H., Jordan, A. H., Weathers, F. W., Resick, P. A., Dondanville, K. A., Hall-Clark, B., Foa, E. B., Young-McCaughan, S., Yarvis, J. S., Hembree, E. A., Mintz, J., Peterson, A. L., Litz, B., STAR Consortium. (2016). Psychometric analysis of the PTSD Checklist-5 (PCL-5) among treatment-seeking military service members. Psychological Assessment,28(11), 1392–1403. https://doi.org/10.1037/pas0000260CrossRefPubMed Wortmann, J. H., Jordan, A. H., Weathers, F. W., Resick, P. A., Dondanville, K. A., Hall-Clark, B., Foa, E. B., Young-McCaughan, S., Yarvis, J. S., Hembree, E. A., Mintz, J., Peterson, A. L., Litz, B., STAR Consortium. (2016). Psychometric analysis of the PTSD Checklist-5 (PCL-5) among treatment-seeking military service members. Psychological Assessment,28(11), 1392–1403. https://​doi.​org/​10.​1037/​pas0000260CrossRefPubMed
go back to reference Zandberg, L. J., Rosenfield, D., McLean, C. P., Powers, M. B., Asnaani, A., & Foa, E. B. (2016). Concurrent treatment of posttraumatic stress disorder and alcohol dependence: Predictors and moderators of outcome. Journal of Consulting and Clinical Psychology,84(1), 43–56. https://doi.org/10.1037/ccp0000052CrossRefPubMed Zandberg, L. J., Rosenfield, D., McLean, C. P., Powers, M. B., Asnaani, A., & Foa, E. B. (2016). Concurrent treatment of posttraumatic stress disorder and alcohol dependence: Predictors and moderators of outcome. Journal of Consulting and Clinical Psychology,84(1), 43–56. https://​doi.​org/​10.​1037/​ccp0000052CrossRefPubMed
Metagegevens
Titel
Exploring the Associations of Emotion Regulation and Trait Resilience with the Efficacy of Cognitive Processing Therapy for Active Duty Military Personnel with PTSD
Auteurs
Craig P. Polizzi
Jennifer Schuster Wachen
Casey L. Straud
Jim Mintz
Allison L. Baier
Katherine A. Dondanville
Stacey Young-McCaughan
Brett T. Litz
Jeffrey S. Yarvis
Alan L. Peterson
Patricia A. Resick
for the STRONG STAR Consortium
Publicatiedatum
17-01-2024
Uitgeverij
Springer US
Gepubliceerd in
Cognitive Therapy and Research / Uitgave 4/2024
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI
https://doi.org/10.1007/s10608-023-10457-7