Universität zu Köln

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:	Creators Email ORCID ORCID Put Code Woud, Marcella L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Blackwell, Simon E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Shkreli, Lorika UNSPECIFIED UNSPECIFIED UNSPECIFIED Wuertz, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Cwik, Jan Christopher UNSPECIFIED orcid.org/0000-0002-2290-353X UNSPECIFIED Margraf, Juergen UNSPECIFIED UNSPECIFIED UNSPECIFIED Holmes, Emily A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Steudte-Schmiedgen, Susann UNSPECIFIED UNSPECIFIED UNSPECIFIED Herpertz, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Kessler, Henrik UNSPECIFIED UNSPECIFIED UNSPECIFIED
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:	Keywords Language INTRUSIVE MEMORIES; HAIR CORTISOL; PSYCHOLOGICAL TREATMENTS; PSYCHOMETRIC PROPERTIES; TRAUMA; REAPPRAISAL; INTERVENTION; INDIVIDUALS; ANXIETY; ADULTS Multiple languages Psychiatry; Psychology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/59390