Impact of Self-Blame on Cognitive Processing Therapy: A Comparison of Treatment Outcomes

Abstract

Research suggests that cognitive processing therapy (CPT) may be a particularly well-suited intervention for trauma survivors who endorse self-blame; however, no study has examined the impact of self-blame on response to CPT. Accordingly, the current study compared response to CPT between two groups of veterans seeking residential treatment for posttraumatic stress disorder (PTSD). In one group, participants endorsed low self-blame at pretreatment (n = 133) and in the other group, participants endorsed high self-blame (n = 133). Results from multilevel modeling analysis suggest that both groups experienced significant reductions in PTSD symptoms as measured by the PTSD Checklist, B = -1.58, SE = 0.11; 95% CI [-1.78, -1.37]; t(1654) = -14.97, p < .001. After controlling for pretreatment symptom severity and additional covariates, there was no difference in treatment response between the low- and high-self-blame groups, Time × Self-blame interaction: B = 0.18, SE = 0.12; 95% CI = [-0.06, 0.42]; t(1646) = 1.49, p = .138. This suggests that CPT is an effective treatment for individuals exposed to trauma, regardless of level of self-blame.