Woud, Marcella L., Blackwell, Simon E., Shkreli, Lorika, Wuertz, Felix, Cwik, Jan Christopher ORCID: 0000-0002-2290-353X, Margraf, Juergen, Holmes, Emily A., Steudte-Schmiedgen, Susann, Herpertz, Stephan and Kessler, Henrik (2021). The Effects of Modifying Dysfunctional Appraisals in Posttraumatic Stress Disorder Using a Form of Cognitive Bias Modification: Results of a Randomized Controlled Trial in an Inpatient Setting. Psychother. Psychosom., 90 (6). S. 386 - 403. BASEL: KARGER. ISSN 1423-0348

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Abstract

Introduction: Dysfunctional appraisals about traumatic events and their sequelae are a key mechanism in posttraumatic stress disorder (PTSD). Experimental studies have shown that a computerized cognitive training, cognitive bias modification for appraisals (CBM-APP), can modify dysfunctional appraisals and reduce analogue trauma symptoms amongst healthy and subclinical volunteers. Objective: We aimed to test whether CBM-APP could reduce dysfunctional appraisals related to trauma reactions in PTSD patients, and whether this would lead to improvements in PTSD symptoms. Methods: We compared CBM-APP to sham training in a parallel-arm proof-of-principle double-blind randomized controlled trial amongst 80 PTSD patients admitted to an inpatient clinic. Both arms comprised a training schedule of 8 sessions over a 2-week period and were completed as an adjunct to the standard treatment programme. Results: In intention-to-treat analyses, participants receiving CBM-APP showed a greater reduction in dysfunctional appraisals on a scenario task from pre- to posttraining (primary outcome) assessments, compared to those receiving sham training (d = 1.30, 95% CI 0.82-1.80), with between-group differences also found on the Posttraumatic Cognitions Inventory (PTCI; d = 0.85, 95% CI 0.39-1.32) and the PTSD Checklist for DSM-5 (PCL-5; d = 0.68, 95% CI 0.23-1.14), but not for long-term cortisol concentrations (d = 0.25, 95% CI -0.28 to 0.78). Reductions in dysfunctional appraisals assessed via the scenario task correlated with reductions on the PTCI, PCL-5, and hair cortisol concentrations from pre- to posttraining time points. Conclusions: Results support dysfunctional appraisals as a modifiable cognitive mechanism, and that their proximal modification transfers to downstream PTSD symptoms. These findings could open new avenues for improving present therapeutic approaches.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Woud, Marcella L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Blackwell, Simon E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Shkreli, LorikaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wuertz, FelixUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cwik, Jan ChristopherUNSPECIFIEDorcid.org/0000-0002-2290-353XUNSPECIFIED
Margraf, JuergenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Holmes, Emily A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Steudte-Schmiedgen, SusannUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Herpertz, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kessler, HenrikUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-593909
DOI: 10.1159/000514166
Journal or Publication Title: Psychother. Psychosom.
Volume: 90
Number: 6
Page Range: S. 386 - 403
Date: 2021
Publisher: KARGER
Place of Publication: BASEL
ISSN: 1423-0348
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
INTRUSIVE MEMORIES; HAIR CORTISOL; PSYCHOLOGICAL TREATMENTS; PSYCHOMETRIC PROPERTIES; TRAUMA; REAPPRAISAL; INTERVENTION; INDIVIDUALS; ANXIETY; ADULTSMultiple languages
Psychiatry; PsychologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/59390

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