OBJECTIVE In recent years, it has been suggested that the modification of dysfunctional posttraumatic cognitions plays a central role as a mechanism of change in cognitive behavioral therapy (CBT) for posttraumatic stress disorder (PTSD). Indeed, several studies have shown that changes in dysfunctional posttraumatic cognitions precede and predict symptom change. However, these studies have investigated the influence on overall symptom severity-despite the well-known multidimensionality of PTSD. The present study therefore aimed to explore differential associations between change in dysfunctional conditions and change in PTSD symptom clusters. METHOD As part of a naturalistic effectiveness study evaluating trauma-focused cognitive behavioral therapy for PTSD in routine clinical care, 61 patients with PTSD filled out measures of dysfunctional posttraumatic cognitions and PTSD symptom severity every five sessions during the course of treatment. Lagged associations between dysfunctional cognitions and symptom severity at the following timepoint were examined using linear mixed models. RESULTS Over the course of therapy, both dysfunctional cognitions and PTSD symptoms decreased. Posttraumatic cognitions predicted subsequent total PTSD symptom severity, although this effect was at least partly explained by the time factor. Moreover, dysfunctional cognitions predicted three out of four symptom clusters as expected. However, these effects were no longer statistically significant when the general effect for time was controlled for. CONCLUSION The present study provides preliminary evidence that dysfunctional posttraumatic cognitions predict PTSD symptom clusters differentially. However, different findings when employing a traditional versus a more rigorous statistical approach make interpretation of findings difficult. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

中文翻译：

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功能失调的创伤后认知的变化是否可以差异预测 PTSD 症状群？

目的 近年来，有人提出，作为创伤后应激障碍 (PTSD) 认知行为疗法 (CBT) 的改变机制，功能失调的创伤后认知的改变起着核心作用。事实上，一些研究表明，功能失调的创伤后认知的变化先于并预测症状的变化。然而，这些研究调查了对整体症状严重程度的影响——尽管 PTSD 具有众所周知的多维性。因此，本研究旨在探讨功能障碍状况的变化与 PTSD 症状群的变化之间的差异关联。方法 作为一项自然主义有效性研究的一部分，该研究评估了常规临床护理中针对 PTSD 的创伤聚焦认知行为疗法，61 名 PTSD 患者在治疗过程中每五个疗程填写一次创伤后认知功能障碍和 PTSD 症状严重程度的测量值。使用线性混合模型检查以下时间点的功能障碍认知与症状严重程度之间的滞后关联。结果 在治疗过程中，认知功能障碍和 PTSD 症状均有所减轻。创伤后认知预测了随后的总体 PTSD 症状严重程度，尽管这种影响至少部分可以用时间因素来解释。此外，功能失调的认知预测了四分之三的症状群，正如预期的那样。然而，当控制时间的一般影响时，这些影响不再具有统计学意义。结论 本研究提供了初步证据，表明功能失调的创伤后认知对 PTSD 症状群的预测存在差异。然而，采用传统统计方法与更严格的统计方法时的不同发现使得对发现的解释变得困难。（PsycInfo 数据库记录 (c) 2023 APA，保留所有权利）。