The Impact of Cognitive Processing Therapy On Quality of Life and Healthcare Use in Veterans with Posttraumatic Stress Disorder Due to Military Sexual Trauma
Fekadu, Rahel Abay
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BACKGROUND: Military Sexual Trauma (MST) is a psychological trauma that resulted from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment (U.S. Code (1720D of Title 38)). Research indicates that MST is associated with increased likelihood of developing Posttraumatic Stress Disorder (PTSD). Veterans who are diagnosed with PTSD due to MST experience a range of comorbid disorders and psychological sequelae including impaired quality of life (Suris et al., 2006), and utilized more primary healthcare services compared to those without PTSD (Frayne, Chiu, Iqbal, Berg, Laungani, Cronkite, Pavao, & Kimerling, 2010). The current study seeks to examine the effectiveness of Cognitive Processing Therapy (CPT), compared to Present Centered Therapy (PCT), on quality of life, health related quality of life and healthcare utilization in veterans who were diagnosed with PTSD due to MST. SUBJECTS: One hundred and ninety veterans with MST were enrolled in to the study and randomized into either CPT or PCT. However, due to fidelity issues data were analyzed for Eighty-six (72 female and 14 male) veterans. METHOD: Data for the proposed study is taken from a larger randomized controlled clinical trial that was conducted at a large Southwestern Veteran Administration Medical Center to evaluate the effectiveness of Cognitive Processing Therapy (CPT) in comparison with Present Centered Therapy (PCT) for PTSD due to MST (Suris et al., 2013). Participants received 12 therapy sessions, bi-weekly, over a six-week period. Data were acquired using face-to-face interviews and written questionnaires at baseline, treatment completion, and at two-month, four-month, and six-month follow-ups. RESULTS: Participants in both treatments did not differ in terms of health related quality of life, quality of life, and healthcare utilization. However, participants in both conditions reported improvement on three of the SF-36 subscales (General Mental Health, Role Limitation Due to Emotional Problems and Vitality), quality of life, and healthcare utilization subscales (Psychotherapy, Outpatient, Hospitalization). DISCUSSION: Although we failed to reject the null hypothesis, the trend indicates that both CPT and PCT are efficacious in terms of improving subjective wellbeing and health related quality of life as well as lowering health care consumption.