Mechanisms of Change in Trauma-Focused Treatment for PTSD: The Role of Rumination
Schumm H, Krüger-Gottschalk A, Dyer A, Pittig A, Cludius B, Takano K, Alpers GW, Ehring T (2022)
Publication Type: Journal article, Original article
Publication year: 2022
Journal
Original Authors: Hannah Schumm, Antje Krüger-Gottschalk, Anne Dyer, Andre Pittig, Barbara Cludius, Keisuke Takano, Georg W. Alpers, Thomas Ehring
Book Volume: 148
Pages Range: 104009
Article Number: 104009
DOI: 10.1016/j.brat.2021.104009
Abstract
Objective
Cognitive behavioral therapy (CBT) has been well established in the treatment of posttraumatic stress disorder (PTSD). In recent years, researchers have begun to investigate its underlying mechanisms of change. Dysfunctional cognitive content, i.e. excessively negative appraisals of the trauma or its consequences, has been shown to predict changes in PTSD symptoms over the course of treatment. However, the role of change in cognitive processes, such as trauma-related rumination, needs to be addressed. The present study investigates whether changes in rumination intensity precede and predict changes in symptom severity. We also explored the extent to which symptom severity predicts rumination.
Method
As part of a naturalistic effectiveness study evaluating CBT for PTSD in routine clinical care, eighty-eight patients with PTSD completed weekly measures of rumination and symptom severity. Lagged associations between rumination and symptoms in the following week were examined using linear mixed models.
Results
Over the course of therapy, both ruminative thinking and PTSD symptoms decreased. Rumination was a significant predictor of PTSD symptoms in the following week, although this effect was at least partly explained by the time factor (e.g., natural recovery or inseparable treatment effects). Symptom severity predicted ruminative thinking in the following week even with time as an additional predictor.
Conclusions
The present study provides preliminary evidence that rumination in PTSD is reduced by CBT for PTSD but does not give conclusive evidence that rumination is a mechanism of change in trauma-focused treatment for PTSD.
Authors with CRIS profile
Involved external institutions
Ludwig-Maximilians-Universität (LMU)
Germany (DE)
Universität Mannheim
Germany (DE)
Zentralinstitut für Seelische Gesundheit
Germany (DE)
Westfälische Wilhelms-Universität (WWU) Münster
Germany (DE)
Germany (DE)
Universität Mannheim
Germany (DE)
Zentralinstitut für Seelische Gesundheit
Germany (DE)
Westfälische Wilhelms-Universität (WWU) Münster
Germany (DE)
How to cite
APA:
Schumm, H., Krüger-Gottschalk, A., Dyer, A., Pittig, A., Cludius, B., Takano, K.,... Ehring, T. (2022). Mechanisms of Change in Trauma-Focused Treatment for PTSD: The Role of Rumination. Behaviour Research and Therapy, 148, 104009. https://doi.org/10.1016/j.brat.2021.104009
MLA:
Schumm, Hannah, et al. "Mechanisms of Change in Trauma-Focused Treatment for PTSD: The Role of Rumination." Behaviour Research and Therapy 148 (2022): 104009.
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