Daily-life associations between posttraumatic stress disorder symptoms, affect, and posttrauma cognitions in the context of the processing of positive memories

Background: Posttraumatic stress disorder (PTSD) is characterized by daily fluctuations in cognitive and affective processes. Little is known about how these processes relate to PTSD severity before and after individuals engage in a therapeutic intervention.Objective: This study used a daily diary design to examine same-day and next-day associations of affect and posttrauma cognitions with posttraumatic stress symptoms (PTSS) during a novel PTSD intervention focused on processing positive memories.Methods: Participants were 70 trauma-exposed adults who completed four sessions of the Processing of Positive Memories Technique (PPMT). Participants completed 21 daily surveys pre - and post- PPMT on PTSS, positive and negative affect, and posttrauma cognitions. Multilevel models and multilevel interrupted time series analyses were used to examine same-day and next-day associations between study variables and changes over time.Results: Multilevel models showed that more negative affect, less positive affect, and more posttrauma cognitions were associated with higher same-day PTSS (ps < .001). In contrast, daily fluctuations in negative affect, positive affect, and posttrauma cognitions did not predict next-day PTSS after accounting for prior-day PTSS. Multilevel interrupted time series models revealed that the same-day association between negative affect and PTSS weakened over time following PPMT (p = .035).Conclusion: Findings emphasize the importance of daily affective and cognitive processes in shaping short-term PTSS trajectories and suggest that PPMT may have its most enduring effects on the association between negative affect processes and PTSS.