Cited by 235Posttraumatic Stress Disorder ResearchPsychotherapy Techniques and ApplicationsPsychoanalysis and Psychopathology Research

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Cognitive change predicts symptom reduction with cognitive therapy for posttraumatic stress disorder

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Kleim, Birgit, Grey, Nick, Wild, Jennifer, Nussbeck, Fridtjof W., Stott, Richard, Hackmann, Ann, Clark, David M., Ehlers, Anke·2013·Journal of Consulting and Clinical Psychology

DOI 10.1037/a0031290PMC PMC3665307

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Abstract

OBJECTIVE: There is a growing body of evidence for the effectiveness of trauma-focused cognitive behavior therapy (TF-CBT) for posttraumatic stress disorder (PTSD), but few studies to date have investigated the mechanisms by which TF-CBT leads to therapeutic change. Models of PTSD suggest that a core treatment mechanism is the change in dysfunctional appraisals of the trauma and its aftermath. If this is the case, then changes in appraisals should predict a change in symptoms. The present study investigated whether cognitive change precedes symptom change in Cognitive Therapy for PTSD, a version of TF-CBT. METHOD: The study analyzed weekly cognitive and symptom measures from 268 PTSD patients who received a course of Cognitive Therapy for PTSD, using bivariate latent growth modeling. RESULTS: Results showed that (a) dysfunctional trauma-related appraisals and PTSD symptoms both decreased significantly over the course of treatment, (b) changes in appraisals and symptoms were correlated, and (c) weekly change in appraisals significantly predicted subsequent reduction in symptom scores (both corrected for the general decrease over the course of therapy). Changes in PTSD symptom severity did not predict subsequent changes in appraisals. CONCLUSIONS: The study provided preliminary evidence for the temporal precedence of a reduction in negative trauma-related appraisals in symptom reduction during trauma-focused CBT for PTSD. This supports the role of change in appraisals as an active therapeutic mechanism.

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Authors: Kleim, B., Grey, N., Wild, J., Nussbeck, F. W., Stott, R., Hackmann, A., Clark, D. M., & Ehlers, A.
Affiliations: King's College London (GB)
University of Zurich (CH)
ORCID: Kleim, Birgit
Wild, Jennifer
Nussbeck, Fridtjof W.
Stott, Richard
Clark, David M.
Ehlers, Anke
Venue: Journal of Consulting and Clinical Psychology
Publisher: American Psychological Association (APA)
Published: 2013-06
Volume: 81
Issue: 3
Pages: 383-393
ISSN: 0022-006X (ISSN-L)
1939-2117
DOI: 10.1037/a0031290
PMC: PMC3665307
OpenAlex: W2122872879
Cited by: 235
References: 64
Citations by year: 2026: 7 · 2025: 9 · 2024: 24 · 2023: 20 · 2022: 12 · 2021: 18 · 2020: 29 · 2019: 34 · 2018: 15 · 2017: 15 · 2016: 20 · 2015: 17 · 2014: 9 · 2013: 5
FWCI: 11.22
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: other-oa
www.apa.org/pubs/journals/resources/open-access.aspx (vor)
Locations: Journal of Consulting and Clinical Psychology (publishedVersion, other-oa)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, other-oa)
KOPS (University of Konstanz) (submittedVersion)
Research Portal (King's College London) (submittedVersion)
PUB – Publications at Bielefeld University (Bielefeld University) (submittedVersion)
Publikationen an der Universität Bielefeld (Universität Bielefeld) (submittedVersion)
Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
Zurich Open Repository and Archive (University of Zurich)
Funders: Wellcome Trust (069777)
National Institute for Health Research Biomedical Research Centre for Mental Health
King’s College London
National Institute for Health Research Oxford Cognitive Health Clinical Research Facility
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords: post-traumatic stress disorder, trauma-focused cognitive behavioral therapy, therapeutic mechanisms, cognitive change, symptom change, temporal precedence
MeSH terms: Adult, Female, Humans, Male, Middle Aged, Models, Psychological, Predictive Value of Tests, Stress Disorders, Post-Traumatic, Cognitive Behavioral Therapy, Treatment Outcome

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Cognitive change predicts symptom reduction with cognitive therapy for posttraumatic stress disorder

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