The Role of Weekly Changes in Rumination on PTSD Symptoms in U.S. Army Soldiers Receiving Cognitive Processing Therapy
Combat-related post-traumatic stress disorder (PTSD) has increase substantially over the last few decades in active duty military populations. PTSD is a mental health condition initiated by experiencing or witnessing a salient, terrifying, traumatic event where individuals perceive the event as life-threatening. It is characterized by intrusive cognitions, avoidance of memories, situations, or places, negative thinking or mood, hyperarousal, nightmares, and a host of comorbid mental health conditions. Research over that last few decades has provided models for maintenance of the disorder, with intrusive rumination as an important underlying mechanism of PTSD. No study to date has been able to establish a clear causal relationship between rumination and PTSD symptom severity in an active-duty US military population. Furthermore, many studies evaluate the relationship outside of the context of treatment, disallowing implications to be drawn about the treatment process. The current project evaluates the relationship between changes in rumination and future PTSD symptom recovery in active-duty U.S. service members throughout a 12-week CPT program with a longitudinal bivariate latent difference score model. Results suggest a dynamic relationship between PTSD recovery and rumination overall. However, analyses of subscale items suggest a statistically causal relationship, with reductions in rumination preceding PTSD symptom recovery for the re-experiencing and avoidance subscale items. Clinical implications are discussed.