Exploring the associations of emotion regulation and trait resilience with the efficacy of cognitive processing therapy for active duty military personnel with PTSD

Polizzi, C. P., Wachen, J. S., Straud, C. L., Mintz, J., Baier, A. L., Dondanville, K. A., Young-McCaughan, S., Litz, B. T., Yarvis, J. S., Peterson, A. L., & Resick, P. A., on behalf of the STRONG STAR Consortium
Jan 18, 2024

Cognitive Therapy and Research. Advance online publication.

Background: Military personnel who complete cognitive processing therapy (CPT) can still experience residual symptoms of posttraumatic stress disorder (PTSD). Gaining a deeper understanding of the characteristics that influence response to CPT may increase the likelihood of treatment success. Emotion regulation and trait resilience are associated with PTSD severity and may influence treatment response in active duty service members with PTSD.

Methods: This secondary analysis explored the association among reports of baseline emotion regulation (Cognitive Emotion Regulation Questionnaire-Short Form) and trait resilience (Response to Stressful Experiences Scale) with PTSD severity reductions in a sample of active duty service members (N = 268) who participated in a clinical trial that compared groupdelivered and individual CPT. Population averaged models were utilized to examine if baseline predictors were related to change in PTSD severity from pre- to posttreatment.

Results: Trait resilience predicted PTSD severity changes such that participants who reported less trait resilience at baseline demonstrated greater PTSD severity reductions over a course of CPT. There was also a main effect of adaptive emotion regulation on PTSD severity. Post-hoc correlation analyses revealed that baseline adaptive emotion regulation was positively associated with PTSD severity at pre- and posttreatment.

Conclusions: Findings imply that service members with lower trait resilience may particularly benefit from CPT. Whether trait resilience moderates PTSD outcomes specific to CPT will require a trial with an alternative comparison treatment arm.