The current study sought to determine if different spheres of social adjustment, social and leisure, family, and work and income improved immediately following a course of cognitive processing therapy (CPT) when compared with those on a waiting list in a sample of 46 U.S. veterans diagnosed with posttraumatic stress disorder (PTSD). We also sought to determine whether changes in different PTSD symptom clusters were associated with changes in these spheres of social adjustment. Overall social adjustment, extended family relationships, and housework completion significantly improved in the CPT versus waiting-list condition, η(2) = .08 to .11. Hierarchical multiple regression analyses revealed that improvements in total clinician-rated PTSD symptoms were associated with improvements in overall social and housework adjustment. When changes in reexperiencing, avoidance, emotional numbing, and hyperarousal were all in the model accounting for changes in total social adjustment, improvements in emotional numbing symptoms were associated with improvements in overall social, extended family, and housework adjustment (β = .38 to .55). In addition, improvements in avoidance symptoms were associated with improvements in housework adjustment (β = .30), but associated with declines in extended family adjustment (β = -.34). Results suggest that it is important to consider the extent to which PTSD treatments effectively reduce specific types of symptoms, particularly emotional numbing and avoidance, to generally improve social adjustment.
A team of clinicians at a small rural Veterans' Health Administration (VHA) medical center piloted a brief psychological intervention for posttraumatic stress in a primary mental health care setting. Symptom measures were completed by veterans before and after receiving the brief trauma treatment (BTT), and were then analyzed using paired t tests. In our uncontrolled study, we found a statistically insignificant improvement in symptoms of posttraumatic stress disorder, though there were statistically significant, but not clinically significant, improvements in depression and general anxiety. The intervention may enhance subsequent specialty mental health engagement. Fifty-one veterans (62.20%) went on to receive psychotherapy in a specialty mental health setting, which represents a substantial increase in specialty psychotherapy engagement compared to reports elsewhere in the literature. Lack of controlled comparison precludes definitive conclusions, but the current preliminary results support future studies of brief psychological interventions in primary care settings, including randomized controlled comparisons.
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