Cited by 207Posttraumatic Stress Disorder ResearchPsychotherapy Techniques and ApplicationsSleep and related disorders

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A meta-analytic review of cognitive processing therapy for adults with posttraumatic stress disorder

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Asmundson, Gordon J. G., Thorisdottir, Audur S., Roden-Foreman, Jacob W., Baird, Scarlett O., Witcraft, Sara M., Stein, Aliza T., Smits, Jasper A. J., Powers, Mark B·2019·Cognitive Behaviour Therapy

DOI 10.1080/16506073.2018.1522371

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Abstract

Numerous studies have demonstrated the efficacy of cognitive processing therapy (CPT) for treating posttraumatic stress disorder (PTSD). Two prior meta-analyses of studies are available but used approaches that limit conclusions that can be drawn regarding the impact of CPT on PTSD outcomes. The current meta-analysis reviewed outcomes of trials that tested the efficacy of CPT for PTSD in adults and evaluated potential moderators of outcomes. All published trials comparing CPT against an inactive control condition (i.e. psychological placebo or wait-list) or other active treatment for PTSD in adults were included, resulting in 11 studies with a total of 1130 participants. CPT outperformed inactive control conditions on PTSD outcome measures at posttreatment (mean Hedges' g = 1.24) and follow-up (mean Hedges' g = 0.90). The average CPT-treated participant fared better than 89% of those in inactive control conditions at posttreatment and 82% at follow-up. Results also showed that CPT outperformed inactive control conditions on non-PTSD outcome measures at posttreatment and follow-up and that CPT outperformed other active treatments at posttreatment but not at follow-up. Effect sizes of CPT on PTSD symptoms were not significantly moderated by participant age, number of treatment sessions, total sample size, length of follow-up, or group versus individual treatment; but, older studies had larger effect sizes and percent female sex moderated the effect of CPT on non-PTSD outcomes. These meta-analytic findings indicate that CPT is an effective PTSD treatment with lasting benefits across a range of outcomes.

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“…about what one could or should have done differently at the forefront of the survivor’s thoughts, consequently promoting secondary emotional responses (e.g., shame, guilt; Asmundson et al., 2019) and avoidance behaviors (e.g., substance use, engaging in risky sexual behavior; Werner et al., 2018).”
Treatment of trauma - cognitive processing therapy or prolonged exposure? Analysis of leading approaches within the cognitive-behavioral paradigm
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“As part of the treat - ment process, the patient acquires and reinforces adaptive beliefs related to trauma and everyday coping strategies [13].”
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“To address this need, Vujanovic and colleagues developed a highly novel and scalable trauma-focused treatment that represents the integration of two evidence-based treatments for PTSD and substance use disorders: CPT and RP (Asmundson et al., 2019; Marlatt & Donovan, 2005; Vujanovic et al., 2018).”
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“…disorder (PTSD), such as cognitive processing therapy (CPT; Resick et al., 2024), directly target the mechanism of cognitive reappraisal (e.g., Asmundson et al., 2019), and, relatedly, changes in trauma-related cognitions have been found to mediate changes in PTSS (Kangaslampi & Peltonen,…”
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“Writing about negative experiences is a common therapeutic tool used to help clients process information (Asmundson et al., 2019).”
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“…smaller effects for CPT (Lenz et al., 2014; Raines et al., 2024), while older age and trauma type have also been linked to differential effects for PE (McLean et al., 2022), and findings for sex as a moderator remain mixed across CPT-focused reviews (Asmundson et al., 2019; Raines et al., 2024).”
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Evaluating evidence based options for initial PTSD treatment non-response: A randomized controlled trial protocol
Held, P., Hutzler, I., Warren, M., Streubel, O., Pridgen, S., Smith, D. L., Cloître, M., ROTHBAUM, B. O., & Kaysen, D. L. (2026) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2026.101685
“…for DSM-5 ; PCL-5, PTSD Checklist for DSM-5 ; CAB, Community Advisory Board; LMMs, linear mixed effects models. reductions in PTSD symptoms, with benefits documented as far out as a decade post-treatment [12], as well as improvements in quality of life, work, home, and social functioning [13].”

Authors: Asmundson, G. J. G., Thorisdottir, A. S., Roden-Foreman, J. W., Baird, S. O., Witcraft, S. M., Stein, A. T., Smits, J. A. J., & Powers, M. B.
Affiliations: University of Regina (CA)
Baylor University Medical Center (US)
The University of Texas at Austin (US)
University of Mississippi (US)
Corresponding author: Asmundson, Gordon J. G.
ORCID: Asmundson, Gordon J. G.
Thorisdottir, Audur S.
Roden-Foreman, Jacob W.
Baird, Scarlett O.
Witcraft, Sara M.
Stein, Aliza T.
Smits, Jasper A. J.
Powers, Mark B
Venue: Cognitive Behaviour Therapy
Publisher: Informa UK Limited
Published: 2018-10-18
Volume: 48
Issue: 1
Pages: 1-14
ISSN: 1650-6073 (ISSN-L)
1651-2316
DOI: 10.1080/16506073.2018.1522371
OpenAlex: W2897437472
Cited by: 207
References: 48
Citations by year: 2026: 30 · 2025: 44 · 2024: 35 · 2023: 27 · 2022: 18 · 2021: 31 · 2020: 10 · 2019: 11 · 2018: 1
FWCI: 2.25
Type: journal article
Language: en
Open access: green
hdl.handle.net
Locations: Cognitive Behaviour Therapy (publishedVersion)
PubMed (publishedVersion)
QSpace (Queen's University Library) (submittedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords: cognitive processing therapy, post-traumatic stress disorder, treatment moderators, sex differences in treatment response
MeSH terms: Humans, Stress Disorders, Post-Traumatic, Cognitive Behavioral Therapy, Treatment Outcome

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A meta-analytic review of cognitive processing therapy for adults with posttraumatic stress disorder

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