Shorter communicationChanges in negative cognitions mediate PTSD symptom reductions during client-centered therapy and prolonged exposure for adolescents☆
Section snippets
Participants
The current study analyzed data from the original RCT described in Foa et al. (2013). Participants were 61 adolescent girls between the ages of 13 and 18 (M age = 15.3, SD = 1.5) who were seeking treatment at a rape crisis center in Philadelphia, Women Organized Against Rape (WOAR). For inclusion in the study, participants must have a primary DSM-IV diagnosis of current or subthreshold (i.e. ≥1 re-experiencing symptom, ≥2 avoidance symptoms, ≥2 arousal symptoms) PTSD resulting from sexual abuse
Overall analyses
We obtained data from participants at 225 (92%) out of a possible 244 total assessments (pre-, mid-, post-treatment and 3-month follow-up assessments for 61 participants). As expected, outcomes 3-months post-treatment were superior in PE-A compared to CCT across all three measures, b = 11.70, t(123) = 5.19, p < .001 for CPSS, b = 6.69, t(86) = 3.39, p = .001 for CDI, and b = 10.67, t(112) = 3.59, p < .001 for CPTAS. In addition, the slopes of improvement were faster in PE-A than in CCT for all
Discussion
This study investigated a key assumption of emotional processing theory for PTSD (Foa et al., 2006, Foa and Kozak, 1986), namely, that reductions in negative trauma-related cognitions are a key driver of recovery from PTSD. This is the first study to show that change in negative trauma-related cognitions is a mechanism of PE in an adolescent-only sample. Our results are consistent with findings from prior adult studies that examined the relationships between negative cognitions and symptoms of
Conflict of interest
None.
References (29)
- et al.
A treatment outcome study for sexually abused preschool children: initial findings
Journal of the American Academy of Child & Adolescent Psychiatry
(1996) - et al.
A prospective investigation of the role of cognitive factors in persistent posttraumatic stress disorder (PTSD) after physical or sexual assault
Behaviour Research and Therapy
(2001) - et al.
Posttraumatic stress disorder symptoms in trauma-exposed college students: the role of trauma-related cognitions, gender and negative affect
Journal of Anxiety Disorders
(2007) - et al.
A meta-analytic review of prolonged exposure for posttraumatic stress disorder
Clinical Psychology Review
(2010) - et al.
Cognitive-behavioral therapy for PTSD in children and adolescents: a preliminary randomized controlled trial
Journal of the American Academy of Child & Adolescent Psychiatry
(2007) Cognitive and affective development in adolescence
Trends in Cognitive Sciences
(2005)- et al.
The moderator–mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations
Journal of Personality and Social Psychology
(1986) - et al.
PTSD: treatment efficacy and future directions
Psychiatric Times
(2007) - et al.
Client-centered therapy treatment manual
(1996) - et al.
Prolonged exposure therapy for adolescents with PTSD: emotional processing of traumatic experiences: therapist guide
(2009)
The Posttraumatic Cognitions Inventory (PTCI): development and validation
Psychological Assessment
Randomized trial of prolonged exposure for posttraumatic stress disorder with and without cognitive restructuring: outcome at academic and community clinics
Journal of Consulting and Clinical Psychology
Emotional processing theory: an update
The child PTSD symptom scale (CPSS): a preliminary examination of its psychometric properties
Journal of Clinical Child Psychology
Cited by (0)
- ☆
This study was supported by National Institute of Health, Grant 5-R01-MH-074505-04, PI: Edna Foa.