Bidirectional relationships between posttraumatic stress disorder and social functioning during cognitive processing therapy
Open accessAbstract
This study investigated temporal relationships between posttraumatic stress symptoms and two indicators of social functioning during cognitive processing therapy. Participants were 176 patients (51.5% female, M age = 39.46 [SD = 11.51], 89.1% White, 42.6% active duty military/veteran) who participated in at least two assessment time points during a trial of cognitive processing therapy. Posttraumatic stress disorder (PTSD) symptoms (PTSD Checklist for DSM-IV) and interpersonal relationship and social role functioning problems (Outcome Questionnaire-45) were assessed prior to each of 12 sessions. Multivariate multilevel lagged analyses indicated that interpersonal relationship problems predicted subsequent PTSD symptoms (b = .22, SE = 0.09, cr = 2.53, p = .01, pr = .46) and vice versa (b = .05, SE = 0.02, cr = 2.11, p = .04, pr = .16); and social role functioning problems predicted subsequent PTSD symptoms (b = .21, SE = 0.10, cr = 2.18, p = .03, pr = .16) and vice versa (b = .06, SE = 0.02, cr = 3.08, p < .001, pr = .23). Military status moderated the cross-lag from social role functioning problems to PTSD symptoms (b = -.35, t = -2.00, p = .045, pr = .16). Results suggest a robust association between PTSD symptoms and social functioning during cognitive processing therapy with a reciprocal relationship between PTSD symptoms and social functioning over time. Additionally, higher social role functioning problems for patients with military status indicate smaller reductions in PTSD symptoms from session to session.
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Social support influences outcomes from PTSD treatment approaches such as cognitive processing therapy.
“There is also evidence that social support (and, conversely, social problems) influences outcomes from PTSD treatment approaches, such as cognitive processing therapy [24,25].”
From A Randomized Pilot Study of Acceptance and Commitment Therapy to Improve Social Support for Veterans with PTSD (2022) · cites this paper as [25]
The Discussion (page unavailable) reports that poorer interpersonal and social-role functioning during cognitive processing therapy was associated with smaller subsequent decreases in PTSD symptoms. This supports the claim about social problems and treatment outcomes, but the study measured functioning problems, not social support itself, and its temporal associations do not establish a causal influence. (LLM, conf=0.86)
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References 64 · Cited by 29
Research works printed but not linked: 2
- Lambert MJ, Morton JJ, Hatfield DR, Harmon C, Hamilton S, Shimokawa K, … Burlingame GB (2004b). Administration and scoring manual for the OQ-45.2 (Outcome Ques-tionnaire) (3rd ed.). Wilmington, DE: American Professional Credentialling Services LLC
- Muthén LK and Muthén BO (1998-2012). Mplus User’s Guide. Seventh Edition.
- Authors
- Lord, K. A., Suvak, M. K., Holmes, S., Shields, N., Lane, J. E. M., Sijercic, I., Wagner, A. C., Stirman, S. W., & Monson, C. M.
- Affiliations
- Suffolk University (US)
- Yale University (US)
- Royal Canadian Mounted Police (CA)
- Toronto Metropolitan University (CA)
- VA Palo Alto Health Care System (US)
- Corresponding author
- Lord, Kayla A.
- ORCID
- Venue
- Behavior Therapy
- Publisher
- Elsevier BV
- Published
- 2020-05
- Volume
- 51
- Issue
- 3
- Pages
- 447-460
- ISSN
- 0005-7894 (ISSN-L)
- PMC
- PMC7232057
- OpenAlex
- W2967459795
- Cited by
- 29
- References
- 64
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 7 · 2023: 7 · 2022: 5 · 2021: 4 · 2020: 1
- FWCI
- 2.92
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Behavior Therapy (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- Canadian Institutes of Health Research
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- post-traumatic stress disorder, social functioning, cognitive processing therapy, interpersonal problems, social role functioning, bidirectional relationship, military veterans, treatment response, PTSD symptom change
- MeSH terms
- Social Interaction, Adult, Cognition, Female, Humans, Male, Middle Aged, Stress Disorders, Post-Traumatic, Veterans, Cognitive Behavioral Therapy
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