Negative posttraumatic cognitions and cognitive emotion regulation strategies as predictors of PTSD symptom change during an intensive outpatient program for PTSD

Negative posttraumatic cognitions (NPCs) and cognitive emotion regulation (CER) strategies have both been proposed as predictors of change in evidence-based cognitive behavioral therapies for posttraumatic stress disorder (PTSD). However, they are rarely studied simultaneously, with only one study examining these predictors in a randomized clinical trial of prolonged exposure therapy. It remains to be tested how these variables predict improvements in PTSD severity in real world clinical settings or different delivery formats. Data from 487 military service members and veterans that participated in a 2-week nonrandomized, uncontrolled cognitive processing therapy-based intensive treatment program (ITP) for PTSD were used to evaluate NPCs and CER strategies as predictors of improvements in PTSD severity. Results showed that, in a model with both predictors, decreases in self-focused NPCs, world-focused NPCs, and catastrophizing (CER strategy) were associated with reductions in PTSD severity during treatment and at follow-up. However, these effects were small (<i>R</i>^<i>2</i> ranging from .005 to.04) relative to reductions in depression severity (<i>R2 =</i> .40). Although NPCs and CER strategies significantly predicted reductions in PTSD severity, their overall impact was relatively small in this nonrandomized, uncontrolled ITP. Future research should continue to investigate these and other predictors in a variety of treatment settings.