Cognitive Processes Associated With Sudden Gains in Cognitive Therapy for Posttraumatic Stress Disorder in Routine Care

Milan Wiedemann*, Alecia Nickless, et al.

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)

1 Citation (Scopus)
15 Downloads (Pure)

Abstract

Objective: Although most studies investigating sudden gains in treatments for posttraumatic stress disorder (PTSD) report a positive association between sudden gains and outcomes at the end of treatment, less is known about sudden gains in routine clinical care and the processes involved in their occurrence. This study investigated changes in cognitive factors (negative appraisals, trauma memory characteristics) before, during, and after sudden gains in PTSD symptom severity.

Method: Two samples (N1 = 248, N2 = 234) of patients who received trauma-focused cognitive therapy for PTSD in routine clinical care were analyzed. Mahalanobis distance matching, including the propensity score, was used to compare patients with sudden gains and similar patients without sudden gains. Estimates from both samples were meta-analyzed to obtain pooled effects. 

Results: Patients with sudden gains (n1 = 76, n2 = 87) reported better treatment outcomes in PTSD symptom severity, depression, and anxiety at the end of therapy and follow-up than those without sudden gains. No baseline predictors of sudden gains could be reliably identified. During sudden gains, those with sudden gains had greater changes in both cognitive factors

Original languageEnglish
Pages (from-to)455-469
Number of pages15
JournalJournal of Consulting and Clinical Psychology
Volume88
Issue number5
Early online date5 Mar 2020
DOIs
Publication statusE-pub ahead of print - 5 Mar 2020

Keywords

  • Cognitions
  • Cognitive therapy
  • Mechanisms of change
  • Posttraumatic stress disorder
  • Sudden gains

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