Category: Cultural Diversity / Vulnerable Populations

Symposium

Mechanisms of Change in Cognitive Processing Therapy Among American Indian Women.

Saturday, November 18
3:30 PM - 5:00 PM
Location: Aqua Salon C & D, Level 3, Aqua Level

Keywords: CPT (Cognitive Processing Therapy) | Change Process / Mechanisms | Native Americans
Presentation Type: Symposium

American Indian (AI) communities have rates of violence exposure more than twice the national level (Department of Justice, 2004) and elevated lifetime rates of PTSD (Beals, Belcourt-Dittloff, Garroutte, et al., 2012; Beals, Novins, Whitesell, et al., 2005). However, there are no studies of evidence based PTSD treatments among AIs. Cognitive Processing Therapy (CPT) is a widely used evidence-based treatment for PTSD (Forbes et al., 2010). Within the CPT literature, there is relatively little research testing theorized mechanisms of change or testing CPT within diverse communities. The two theorized mechanisms of action in CPT are emotion regulation (processing of natural emotions) and cognitive restructuring (Resick, Monson, & Chard, 2007). An additional potential mechanism of change is increasing self-efficacy as individuals learn increased coping skills. In this pilot study of CPT-cognitive version (CPT-C) adapted for AI’s we examined change in cognitions, emotion regulation, and self-efficacy as predictors of change in PTSD in 60 AI women. Three path analysis models were used to examine whether change in 1) distress tolerance, 2) post-traumatic maladaptive beliefs, or 3) trauma coping self-efficacy were associated with differences in PTSD symptoms at post-treatment and 3 month follow-up, controlling for baseline symptomatology. Preliminary analyses indicate a one-standard deviation increase in distress tolerance and coping self-efficacy from baseline predicted a 0.5-standard deviation reduction in PTSD symptoms at post-intervention/follow-up assessment (β’s = -.52 to -.45, p’s < .001). A one-standard deviation decrease in maladaptive beliefs from baseline predicted a 0.5-standard deviation reduction in PTSD symptoms at post-intervention/follow-up assessment (β = .48, p = .001). Findings support cognitive restructuring as a means of change in CPT-C. Although self-efficacy and emotion regulation are not explicitly taught, these also appear to be mechanisms of change in CPT-C. 

Debra Kaysen

Professor
University of Washingon

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