Comorbidity in the prediction of Cognitive Processing Therapy treatment outcomes for combat-related posttraumatic stress disorder

D Lloyd; R D V Nixon; T Varker; P Elliott; D Perry; R A Bryant; M Creamer; D Forbes

doi:10.1016/j.janxdis.2013.12.002

Comorbidity in the prediction of Cognitive Processing Therapy treatment outcomes for combat-related posttraumatic stress disorder

J Anxiety Disord. 2014 Mar;28(2):237-40. doi: 10.1016/j.janxdis.2013.12.002. Epub 2013 Dec 22.

Authors

D Lloyd¹, R D V Nixon², T Varker³, P Elliott³, D Perry⁴, R A Bryant⁵, M Creamer³, D Forbes³

Affiliations

¹ Australian Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Vic, Australia. Electronic address: d.lloyd@unimelb.edu.au.
² Australian Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Vic, Australia; School of Psychology, Flinders University, SA, Australia.
³ Australian Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Vic, Australia.
⁴ Veterans and Veterans' Families Counselling Service, Australia.
⁵ School of Psychology, University of New South Wales, NSW, Australia.

PMID: 24507630
DOI: 10.1016/j.janxdis.2013.12.002

Abstract

This paper examines clinical predictors of posttraumatic stress disorder (PTSD) treatment outcomes following Cognitive Processing Therapy (CPT) in Australian military veterans. Fifty nine treatment seeking veterans were enrolled in a randomized controlled trial comparing 12 sessions of CPT (n = 30) with usual treatment (n = 29) at three community-based veterans counseling centers. PTSD and key co-morbidities (depression, anxiety, anger and alcohol use) were measured. Growth curve modeling was used to examine factors which influenced PTSD severity post-treatment. For the CPT condition, baseline anger was the only co-morbidity predictive of change in PTSD severity over time. Participants with higher anger scores showed less of a decrease in PTSD severity over time. Higher anxiety in participants in treatment as usual was significantly associated with better treatment gains. This research suggests that veterans experiencing high levels of anger might benefit from targeted anger reduction strategies to increase the effectiveness of CPT treatment for PTSD.

Keywords: Cognitive Processing Therapy; PTSD; Predictors; Trauma; Treatment; Veterans.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Alcoholism / diagnosis
Alcoholism / epidemiology
Anger
Anxiety / diagnosis
Anxiety / epidemiology
Australia / epidemiology
Cognitive Behavioral Therapy*
Combat Disorders / epidemiology*
Combat Disorders / psychology
Combat Disorders / therapy*
Comorbidity
Depression / diagnosis
Depression / epidemiology
Follow-Up Studies
Humans
Psychiatric Status Rating Scales
Stress Disorders, Post-Traumatic / epidemiology*
Stress Disorders, Post-Traumatic / psychology
Stress Disorders, Post-Traumatic / therapy*
Treatment Outcome
Veterans / psychology*