Date of Award

6-2024

Degree Name

Doctor of Philosophy

Department

Psychology

First Advisor

Scott Gaynor, Ph.D.

Second Advisor

Amy Naugle, Ph.D.

Third Advisor

Ashlee Warnecke, Ph.D.

Fourth Advisor

Elizabeth Torgersen, Ph.D.

Keywords

Brief, CPT, defusion, mechanism, PTSD, trauma

Abstract

Cognitive Processing Therapy (CPT) is a first-line treatment for trauma. CPT is traditionally administered over 12 sessions. This open clinical trial examined the feasibility and efficacy of a 5-session CPT protocol. The abbreviated protocol moves more quickly to the proposed therapeutic mechanism of action, cognitive restructuring, to alter unhelpful traumarelated thoughts and beliefs. The goal is to maintain efficacy while making therapy more efficient and thereby reducing barriers to trauma treatment. Using a repeated measures open clinical trial design (with embedded multiple baselines), 67 adults (M age = 43 years, 90% female, 79% White) with clinically significant post-traumatic stress disorder symptoms were offered 3-5 baseline assessment sessions followed by the 5 CPT sessions. Forty-nine (73%) completed treatment, demonstrating less dropout than is typically observed with CPT. Intent-totreat analyses showed no significant changes during baseline, while statistically significant (and large effect size) improvements in trauma symptoms, negative automatic thoughts, posttraumatic cognitions, cognitive fusion, and psychological flexibility were found during CPT. Overall, brief CPT appeared efficacious in diminishing trauma symptoms by reducing negative thinking and increasing the ability to defuse from thoughts about trauma. Change in cognitive fusion (the tendency to get entangled with or struggle with negative thoughts) was most closely associated with change in trauma symptoms, which has implications for the conceptualization of cognitive restructuring in CPT. While these data are promising and suggest the potential utility of brief CPT, replication of these findings with stronger control conditions is clearly warranted before strong conclusions are drawn.

Access Setting

Dissertation-Open Access

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