Effects of Cognitive Therapy on Symptoms of PTSD and Depression

A large number of individuals with posttraumatic stress (PTSD) also develop symptoms of major depression (MDD). Various treatment approaches aim to reduce symptoms of both MDD and PTSD to lower the risk of social impairment and suicidal ideation that is often present in these individuals. One such method of treatment is cognitive processing therapy (CPT), which incorporates writing activities and cognitive psychotherapy (CPT-C). There is evidence that supports CPT for PTSD and MDD, suggesting that this approach can dramatically reduce symptom severity when PTSD and MDD occur together. However, until now, no study has looked at how each component of CPT, namely the CPT-C and the writing activities, independently influence symptom change in PTSD and MDD separately.

Gabrielle I. Liverant of the VA Boston Healthcare System on the Brockton Campus in Massachusetts wanted to explore this dynamic more closely. In a recent study, Liverant assessed 126 women assigned to either CPT in totality, CPT-C alone, or writing activities alone. The participants had all been diagnosed with PTSD and were evaluated 8 times over a 6 week period of treatment. Liverant discovered that each individual component of CPT worked to decrease symptoms of MDD and PTSD in the same way. Specifically, the women in the CPT-C condition saw decreases in symptoms that were similar to those realized by the women in the CPT full protocol and the condition with writing activities. Also, Liverant found that for all the conditions, symptoms of MDD and PTSD were reduced simultaneously. In other words, improvements in MDD did not lead to improvements in PTSD, and decreases in PTSD symptoms did not predict MDD symptom reductions.

This finding suggests that neither CPT nor its individual components are solely responsible for the reductions in symptoms. “Instead,” added Liverant, “This pattern of results suggests that a third factor (e.g., treatment) influenced change in both disorders simultaneously.” The fact that the writing activities condition worked equally as well as the cognitive condition also indicates that writing about a trauma may lead to cognitive shifts, equal to those realized in exposure experiments. Although these results do provide evidence of the benefits of each individual element of CPT, more research should be conducted to extend these findings to a more diverse participant sample and to individuals with other comorbid conditions.

Liverant, Gabrielle I., Michael K. Suvak, Suzanne L. Pineles, and Patricia A. Resick. Changes in posttraumatic stress disorder and depressive symptoms during cognitive processing therapy: Evidence for concurrent change. Journal of Consulting and Clinical Psychology 80.6 (2012): 957-67. Print.

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  • Leave a Comment
  • Paisley


    December 28th, 2012 at 1:06 PM

    All the more reason for more people who are having problems in their lives to try journaling. There is something so therapeutic about writing, getting those emotions and feelings out on paper that does not feel as threatening as keeping them inside or even talking with someone face to face. I have long utilized writing as a way to alleviate my own stress and to work through problems when I did not have a solution. I hope that this catches on in conjunction with more serious therapy sessions and is able to help others in the same manner that it has often helped me.

  • tracey


    December 28th, 2012 at 3:34 PM

    if two treatments have the same effect and work well that is reason to celebrate.because a treatment appropriate to the patient and to the situation can be employed rather than having to stick with one single solution.

  • derris


    December 28th, 2012 at 10:31 PM

    surprised that simply writing about a trauma can help..maybe all that a trauma victim needs is to express him/herself..the sooner this process is done the better..often people are left alone and disconnected after a trauma.and if they do not have treatments going on this can quickly become something much worse.

    to have someone to talk to or just listen to you without any bias would be a good thing after a traumatic event.can never underestimate the power of expression.

  • Paisley


    December 29th, 2012 at 4:03 AM

    Don’t be surprised that writing about something can help. I know that the first thought would be that this brings it all to the surface and makes is it even harder and more complicated to deal with. But really, there is so much more than that. Yes, it does force you to look it in the eye and deal with it, but I know that this is something that is healthy, and not harmful. It is so much better to let those words flow out of you in this way, a way that is safe and comfortable, than it is to hold it inside. Derris, I hear what you are saying about rather having someone to talk to, and I think that for some people this is the ideal answer. But there is also truth in the fact that writing can also be healing and therapeutic, and i ask that you at least give it that consideration.

  • Ms. Tonja

    Ms. Tonja

    December 29th, 2012 at 12:35 PM

    My daughter has been diagnosed with both anxiety and depression and writes in her journals quite a bit. It really is a refuge for her. Her therapist recommended it, but I honestly thing she would have found it on her own. She really loves to write to begin with and is very good at it.

  • rainn


    December 29th, 2012 at 12:44 PM

    It sure is a great thing that more than one approach will work to treat this affliction. Everyone has a preferred way of doing things and it is great that they can choose which way will work the best for them.

  • P Scott

    P Scott

    December 29th, 2012 at 12:46 PM

    Hopefully this will help out troops who come home scarred by war.

  • James W

    James W

    December 29th, 2012 at 12:49 PM

    P Scott, I was thinking the same thing. Our brave men and women who fight for us really do deserve top notch care upon their return. Hopefully the techniques mentioned here will intervene before the major depressive episodes set in. This country of ours is great but we fail if we don’t take care of the ones working so hard to take care of us.

  • Rhonda


    December 29th, 2012 at 2:05 PM

    If each of the components produces the same effect then is there any need for both together?that would only prolong the treatment duration doesn’t it?

  • Charla


    December 30th, 2012 at 4:31 AM

    I think that with any illness, be it mental or physical, there is always this quest to find this magic formula that will work in any case across the board. But I think that we too have also seen that there is rarely lasting success or even effective treatment that works in this manner all the time. yes, this could get you moving in the right direction, but unfortunately every unique case takes some tweaking to get it right, and I think that this continues to be evidenced here. Something works well for one thing but not for others, so we just have to do a little more work each time to ensure that we hit on that sweet spot for each individual person who is suffering.

  • lindsey


    December 30th, 2012 at 7:17 AM

    undergoing trauma can easily lead to depression.that calls for immediate care.and although writing or journaling may be beneficial I think immediate intervention with treatment including therapy would be the best way soon after the trauma has occurred.

    for me just writing about problems in my mind will not suffice,I would want to talk about and discuss them.

  • shane


    December 30th, 2012 at 3:33 PM

    its good to know that each component delivers the same results.that is because then it is possible to pick and choose the component most suited to a particular client.comfort with a particular component also increases chances of benefiting from it.

  • Heather


    December 31st, 2012 at 5:48 AM

    It has to be disheartening for a patient who goes into treatment to receive help for numerous issues to find that one thing works for one illness, but not necessarily another. I would hope that there could be a way for more times than not to discover a regimen that would help to address all of someone’s symptoms at the same time, so that they feel better all the way around and not just in certain areas of their lives. There can’t be total and complete healing until they arer feeling better as a whole, and stop feeling so disjointed and segmented in their healing.

  • TIM


    December 31st, 2012 at 1:20 PM

    While PTS can turn into a depression,it would be so much better if we could help those with PTS avoid depression and get out of it in the initial stages.It would also be interesting to see if a particular method or component of this treatment is more suitable for a particular stage of the problem,like if those that are in the early stages of depression would react similarly to those who have had depression for a while.

  • barbara


    December 31st, 2012 at 10:24 PM

    the aim of any therapeutic method should be to reduce the symptoms and aid in recovery.as long as these parameters are met and to a sufficient degree there is no reason why a method should be ignored or discarded.whatever works, works, right?

  • Liz


    January 1st, 2013 at 12:02 AM

    Surprising to see putting your thoughts down can help so much. I’ve personally wanted to maintain a journal for quite sometime now but never got started. Maybe I should now seeing as it can benefit your mental health just by jotting down your thoughts.

  • lorraine


    January 2nd, 2013 at 2:21 PM

    I don’t see how this is all good!If therapy is giving no advantages over simple writing,then shouldn’t it be criticized and improved?!Why is no one talking about this?

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