Effectiveness of Cognitive Processing Therapy for Male and Female U.S. Veterans With and Without Military Sexual Trauma

• Published in: Journal of traumatic stress 2015-06, Vol.28 (3), p.174-182
• Main Authors: Voelkel, Emily, Pukay-Martin, Nicole D., Walter, Kristen H., Chard, Kathleen M.
• Format: Article
• Language: English
• Subjects: Adult; Cognitive Therapy; Depression - etiology; Depression - therapy; Female; Humans; Male; Middle Aged; Post traumatic stress disorder; Psychopathology; Residential Treatment; Sex crimes; Sex Factors; Sex Offenses - psychology; Stress Disorders, Post-Traumatic - etiology; Stress Disorders, Post-Traumatic - therapy; Treatment Outcome; United States; Veterans; Veterans - psychology
• ISSN: 0894-9867; 1573-6598
• DOI: 10.1002/jts.22006

Military sexual trauma (MST) affects approximately 2% and 36% of male and female veterans, respectively, (e.g., Allard, Gregory, Klest, & Platt, 2011). Although the deleterious consequences of MST have been clearly established, few studies have explored treatment effectiveness for this population. Using archival data from a residential treatment program, the current study explored the effectiveness of cognitive processing therapy (CPT) in treating full or subthreshold posttraumatic stress disorder (PTSD) to compare U.S. veterans reporting an MST index trauma (MST‐IT) to those without MST‐IT. Of the 481 participants, 40.7% endorsed MST‐IT. Multiway frequency analyses were utilized to compare men and women with and without MST on baseline demographic variables. Hierarchical linear models were constructed to investigate treatment outcome by MST status and sex. Results showed that 44.8%, 23.8%, and 19.6% of the variation in clinician‐ and self‐reported PTSD and depression symptoms were explained by three models. Scores on all outcome measures significantly decreased over time for both groups. Additionally, women demonstrated a sharper decrease in PTSD symptoms over time than men. Lastly, men who reported MST‐IT had higher PTSD symptoms than men without MST‐IT on average. With no control group or random assignment, preliminary findings suggest residential treatment including CPT may be effective for MST‐IT regardless of sex. Resumen El trauma sexual militar (MST por sus siglas en inglés) afecta al 2% y 36% de veteranos de guerra varones y mujeres respectivamente. (ej., Allard et al., 2011). Aunque se ha establecido claramente las consecuencias deletéreas del MST, pocos estudios han explorado tratamientos efectivos para esta población. Usando la información de archivo de programas de tratamientos el estudio actual exploró la eficacia de la Terapia de Procesamiento Cognitivo (CPT) en el tratamiento de Trastorno por Estrés Postraumático (TEPT) en veteranos de guerra norteamericanos, comparando aquellos con y sin trauma sexual militar. De los 481 participantes, 40% reportaron MST. Se utilizó análisis de frecuencia multimodal para comparar hombres y mujeres con y sin MST y variables demográficas de referencia. Se construyeron modelos de regresión lineal para investigar los resultados de estado de MST y género. Los resultados mostraron que el 44,8%, 23,8% y 19,6% de la variación de síntomas de TEPT y de Depresión en la clínica y auto reporte se explicó por 3 modelos.