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Changes in Coping and Negative Cognitions as Mechanisms of Change in Online Treatment for Rape‐Related Posttraumatic Stress Disorder
Author(s) -
Littleton Heather,
Grills Amie
Publication year - 2019
Publication title -
journal of traumatic stress
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.259
H-Index - 134
eISSN - 1573-6598
pISSN - 0894-9867
DOI - 10.1002/jts.22447
Subject(s) - coping (psychology) , clinical psychology , psychology , psychological intervention , cognition , randomized controlled trial , cognitive therapy , posttraumatic stress , cognitive behavioral therapy , psychiatry , medicine
Cognitive behavioral therapy (CBT)–based interventions, including those administered via telepsychology, represent efficacious posttraumatic stress disorder (PTSD) treatments. Despite demonstrated efficacy, limited research has examined mechanisms of change for CBT. We examined trauma‐related cognitions and coping as treatment mechanisms among 46 women who completed a randomized clinical trial of a CBT‐based, telepsychology‐delivered interactive program for rape survivors. The results indicated that both the interactive program, d = 1.5, and the active control condition, a psychoeducational website, d = 1.4, resulted in large reductions in posttest PTSD symptoms. Analysis of residual gain scores showed that reductions in the three types of assessed trauma‐related cognitions were strongly related to reductions in PTSD symptoms among women assigned to the interactive program, r s = .60–.79, but only weakly related to symptom reduction among those assigned to active control, r s = .06–.31. The results also suggest that increases in trauma‐related approach coping were weakly related to reductions in PTSD symptoms among participants in the interactive program, r s = −.16 and −.17, but, conversely, decreases in trauma‐related approach coping were weakly related to reductions in PTSD symptoms among those in the active control group, r s = .07 and .28. Reductions in avoidance coping were modestly related to reductions in PTSD symptoms among women in the interactive program, r s = .38 and .38, but unrelated to changes in PTSD symptoms among those assigned to the active control, r s = .03 and .05. Implications for future work examining mechanisms of change for PTSD treatments are discussed.