Bidirectional Relationships Between Posttraumatic Stress Disorder and Social Functioning During Cognitive Processing Therapy

Social engagement, self‐efficacy, and posttraumatic stress symptoms across 6 months of psychotherapy

“…Our findings suggest that by focusing on improving social engagement in therapy, benefits may extend to improvements in PTS and coping self‐efficacy. This may be especially indicated in light of evidence documenting social dysfunction as a barrier to treatment response (Lord et al, 2019) and engagement in evidence‐based treatments (Sayer et al, 2009), alongside the social disintegration and negative social cognitive‐perceptual biases that are often experienced by individuals seeking trauma treatment (Smith et al, 2018).…”

“…The trauma literature has overwhelmingly operationalized functional support in the form of perceived support that is available from others (e.g., Brewin, Andrews & Valentine, 2000). Evidence supports greater positive change in perceived support is related to lower PTS severity in trauma‐focused treatment (Lord et al, 2019; Price, Gros, Strachan, Ruggiero, & Acierno, 2013; Thrasher, Power, Morant, Marks, & Dalgleish, 2010). However, our ability to apply knowledge of social functioning in posttraumatic interventions has been limited by how we have conceptualized and operationalized the construct.…”

“…The current study was conducted in a naturalistic trauma treatment setting to examine whether and how perceived social engagement, coping self‐efficacy, and PTS influence one another across 6 months of psychotherapy for trauma survivors. Six factors drive the motives for the current study, hypotheses, and analytic strategy: (1) the need to identify mechanisms of change (Kazdin, 2007) in naturalistic treatment settings; (2) the potential importance of perceived social engagement and coping self‐efficacy in trauma treatment (Bandura, 1997; Benight & Bandura, 2004); (3) competing support for social causation and erosion models, without knowledge about the role of perceived social engagement; (4) limited literature examining the role of social perceptual factors in response to trauma‐focused therapy (Lord et al, 2019; Price et al, 2013; Thrasher et al, 2010) with no such studies in naturalistic trauma treatment settings and that specifically examined perceived social engagement; (5) empirical support for both enabling and cultivation models, and; (6) no treatment research that examines the interplay of all three variables in concert. We used a cross‐lagged panel model approach to examine directional effects of the relationship between perceived social engagement and PTS (i.e., social causation and social erosion models; alternative Hypotheses 1 and 2), and directional effects to examine the relationships among perceived social engagement, coping self‐efficacy, and PTS (cultivation and enabling models; alternative Hypotheses 3 and 4).…”

“…Recent research byLord et al (2019) tested possible bidirectional relationships among two dimensions of social functioning (i.e., interpersonal relationship problems; social role functioning) and change in PTS in a controlled context during administration of cognitive processing therapy. Results supported such bidirectional dynamics, indicating that higher PTS symptoms prompted worse social role functioning and interpersonal problems and that worse social role functioning and interpersonal problems prompted worse PTS symptoms.…”

Mental Time Travel in Post-Traumatic Stress Disorder: Current Gaps and Future Directions

“…AMs may be retrieved deliberately (voluntarily) or unexpectedly (involuntarily). AMs are critical for wellbeing and functioning, as they are implicated in numerous clinically-relevant processes, including problem-solving; the creation of self-concept; and the formation and maintenance of social-bonds (Bluck et al, 2005 )— all processes that are dysregulated in PTSD (e.g., Lord et al, 2020 ). Given the integral role of AM in PTSD, it is unsurprising that numerous studies have examined AM alterations related to this disorder.…”