Moderators of PTSD symptom change in group cognitive behavioral therapy and group present centered therapy |
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| Affiliation: | 1. University of Memphis, Department of Psychology, Memphis, TN, USA;2. University of Wyoming, Department of Psychology, Laramie, WY, USA;3. Providence VA Medical Center, Providence, RI, USA;4. VA Boston Healthcare System, Boston, MA, USA;5. Boston University School of Medicine, Department of Psychiatry, Boston, MA, USA;1. University of Arizona, Department of Health Promotion Sciences, 1295 N. Martin Ave., P.O. Box 245209, Tucson, AZ 85724-5209, USA;2. University of Arizona, Department of Psychiatry, 1501 N. Campbell Ave., Tucson, AZ 85724-5002, USA;3. Southern Arizona VA Health Care System, 3601 S. 6th Ave., 116B, Tucson, AZ 85723, USA;4. University of Arizona, Department of Psychology, 1503 E. University Blvd, Tucson, AZ 85721, USA;5. University of Arizona, Department of Medicine, 1501 N. Campbell Ave., Tucson, AZ 85724, USA;6. Harvard Medical School, Division of Sleep Medicine, 164 Longwood Ave., Boston, MA 02115, USA;7. Maimonides Sleep Arts & Sciences, 6739 Academy Rd NE Suite 380, Albuquerque, NM 87109, USA;8. VA Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA 98108, USA;1. Trauma Recovery Center, Cincinnati Veterans Affairs Medical Center, Cincinnati, Ohio USA;2. Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio USA;1. Auburn University, United States;2. Westfield State University, United States |
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| Abstract: | To examine moderators of change during group-based intervention for Posttraumatic Stress Disorder (PTSD), multilevel models were used to assess trajectories of symptom clusters in male veterans receiving trauma focused Group Cognitive Behavioral Treatment (gCBT; N = 84) or non-trauma focused Group Present Centered Therapy (gPCT; N = 91; Sloan et al., 2018). Separate models were conducted for symptom clusters in each intervention, examining pre-treatment PTSD symptoms, pre-treatment depression severity, age, index trauma, and outcome expectancies as potential moderators. Unconditioned growth models for both gCBT and gPCT showed reductions in intrusions, avoidance, negative cognitions/mood, and arousal/reactivity (all p < .001). Distinct moderators of recovery emerged for each treatment. Reductions in avoidance during gCBT were strongest at high levels of pre-treatment PTSD symptoms (low PTSD: p = .964, d = .05; high PTSD: p < .001, d = 1.31) whereas positive outcome expectancies enhanced reductions in cognitions/mood (low Expectancy: p = .120, d = .50; high Expectancy: p < .001, d = 1.13). For gPCT, high levels of pre-treatment depression symptoms negatively impacted change in both intrusion (low depression: p < .001, d = .96; high depression: p = .376, d = .22) and arousal/reactivity (low depression: p < .001, d = .95; high depression: p = .092, d = .39) symptoms. Results support the importance of examining trajectories of change and their moderators for specific treatments, particularly when contrasting trauma focused and non-trauma focused treatments. |
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| Keywords: | Moderator Treatment outcome PTSD Veterans |
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