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J Anxiety Disord. 2018 Oct;59:34-41. doi: 10.1016/j.janxdis.2018.09.001. Epub 2018 Sep 15.

A cognitive processing therapy-based treatment program for veterans diagnosed with co-occurring posttraumatic stress disorder and substance use disorder: The relationship between trauma-related cognitions and outcomes of a 6-week treatment program.

Author information

1
G.V. (Sonny) Montgomery VA Medical Center, 1500 East Woodrow Wilson Drive, Jackson, Mississippi 39216, USA; Department of Psychiatry and Human Behavior, The University of Mississippi Medical Center, 2500 North State St., Jackson, MS 39216, USA. Electronic address: krpeck@uvm.edu.
2
Department of Psychiatry and Human Behavior, The University of Mississippi Medical Center, 2500 North State St., Jackson, MS 39216, USA.
3
G.V. (Sonny) Montgomery VA Medical Center, 1500 East Woodrow Wilson Drive, Jackson, Mississippi 39216, USA; Department of Psychiatry and Human Behavior, The University of Mississippi Medical Center, 2500 North State St., Jackson, MS 39216, USA; VISN 17 Center of Excellence for Research on Returning War Veterans, Central Texas Health Care System, 4800 Memorial Dr., Waco, TX 76711, USA; Department of Psychology and Neuroscience, Baylor University, One Bear Place 97334, Waco, TX 76706, USA; College of Medicine, Texas A&M Health Science Center, 8447 Bryan Rd, Bryan, TX 77807, USA.
4
G.V. (Sonny) Montgomery VA Medical Center, 1500 East Woodrow Wilson Drive, Jackson, Mississippi 39216, USA.
5
G.V. (Sonny) Montgomery VA Medical Center, 1500 East Woodrow Wilson Drive, Jackson, Mississippi 39216, USA; Department of Psychiatry and Human Behavior, The University of Mississippi Medical Center, 2500 North State St., Jackson, MS 39216, USA.

Abstract

Dysfunctional trauma-related cognitions are important in the emergence and maintenance of posttraumatic stress disorder (PTSD) and the modification of such cognitions is a proposed mechanism of trauma treatment. However, the authors are not aware of any research examining trauma-related cognitions as a treatment mechanism in a sample of individuals with comorbid PTSD and substance use disorder (SUD). Accordingly, the present study sought to address this gap in the literature and examined the relationship between trauma-related cognitions and treatment outcomes within a sample of seventy-two veterans diagnosed with PTSD and SUD. Veterans completed a 6-week day CPT-based treatment program that included cognitive processing therapy as a central component. Measures of trauma-related cognitions, PTSD symptoms, depressive symptoms, and trauma-cued substance craving were completed at pre- and post-treatment. As expected, trauma-related cognitions were associated with several PTSD-related variables prior to treatment. Furthermore, results of a within-subjects mediational analysis indicated that maladaptive trauma-related cognitions decreased during the treatment program and accounted for a significant portion of the variance in the reduction of PTSD and depressive symptoms at post-treatment. This study provides support for the position that attempts to modify dysfunctional trauma-related cognitions among veterans with co-occurring PTSD and SUD can lead to desirable treatment outcomes.

KEYWORDS:

Cognitive processing therapy; Mediation; Posttraumatic stress disorder; Substance use disorders; Veterans

PMID:
30248534
DOI:
10.1016/j.janxdis.2018.09.001
[Indexed for MEDLINE]

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