Changing the Way We Think Changes Symptom Severity in PTSD

Appraisals are perceptions people have related to a particular event or emotion. For trauma survivors, appraisals surrounding the traumatic event may result in feelings of guilt, shame, fear, and anger, among others. Changing these appraisals may be the key to unlocking the door to recovery for many people with posttraumatic stress (PTSD). Birgit Kleim of the Department of Psychology at King’s College in London recently led a study that examined whether or not appraisals and change in appraisals predicted change in symptom severity for people undergoing a form of trauma-focused cognitive behavioral therapy known as Cognitive Therapy for PTSD (CT-PTSD).

Kleim assessed 268 individuals with PTSD before, during, and after they underwent the intervention. She found that even though the participants all had varying levels of symptom severity and differing appraisals surrounding their traumas, they all saw significant decreases in symptoms as a result of the CT-PTSD. These results in symptoms were directly predicted by changes in appraisals. Specifically, as the appraisals of the trauma changed for the better, the symptoms diminished. In fact, the majority of the participants were below the clinical threshold for PTSD after the intervention. When Kleim looked to see if the relationship between symptom change and appraisal change was bidirectional, she found it was not.

These results give researchers a clue as to what creates the dynamic change in trauma-focused cognitive therapies. “Our finding that reductions in negative appraisals predict later reductions in PTSD symptoms is thus in direct support of cognitive mediation in CT-PTSD,” said Kleim. It also provides evidence that this type of approach can be just as helpful to people with moderate or severe PTSD symptoms. Another interesting finding was that participants with even highly negative appraisals benefited from the intervention. By understanding the mechanisms that work to afford change, clinicians can focus on addressing those mechanisms as they help clients try to minimize the impact of PTSD.

Reference:
Kleim, B., Grey, N., Wild, J., Nussbeck, F. W., Stott, R., Hackmann, A., Clark, D. M., and Ehlers, A. (2012). Cognitive change predicts symptom reduction with cognitive therapy for posttraumatic stress disorder. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0031290

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  • lacey

    lacey

    January 28th, 2013 at 3:29 PM

    this is true in things that go beyond just PTSD. having been distraught after my project team failed to win at school due to what I thought was my shortcoming, it felt better to hear from my team mates as to just how good the winning team was. if not for that view of the winning team being exceptionally good I would have probably continued to blame and be angry with myself.

    always a good idea to see things through a different lens when it hurts you. maybe you will see that things are much different than you thought of them as before.

  • Scott

    Scott

    January 28th, 2013 at 11:14 PM

    What would be interesting is if they studied how the time period between the traumatic event and the change in appraisal affects the outcome. I would think the longer time there is between the traumatic event and a change in the perception, the more reduced the benefits are. But then it is harder to change the perception closer to the traumatic event. I’d love to learn how this plays out.

  • January

    January

    January 29th, 2013 at 11:12 AM

    Well I should think that it would go without saying that the more positive that you become with one aspect of your life then you are bound to show other positive improvements in other areas too, right?

  • Saddened

    Saddened

    January 29th, 2013 at 5:14 PM

    Lucky to have never been through a trauma but whenever I do ponder over sad events from the past my mood goes further down and I’m left sinking in the sadness.nothing seems to help.This sounds good to have your thoughts help you in recovery but it doesn’t work for me as I can see it.anything wrong with me?

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