Cognitive processes associated with sudden gains in cognitive therapy for posttraumatic stress disorder in routine care

Journal of Consulting and Clinical Psychology
Milan WiedemannA Ehlers

Abstract

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. 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. 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 than matched patients. Meta-analyses of the two sam...Continue Reading

Citations

Dec 3, 2020·Psychological Medicine·Angela NickersonBelinda J Liddell
May 4, 2021·Psychotherapy Research : Journal of the Society for Psychotherapy Research·Anne-Katharina DeisenhoferWolfgang Lutz
Sep 1, 2021·Psychotherapy Research : Journal of the Society for Psychotherapy Research·Andrew Koffmann

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Software Mentioned

R package nlme
RStudio IDE
R
R Core Team
R package suddengains
R package MatchIt
R package metafor

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