The role of time since trauma on treatment outcomes of veterans in two intensive posttraumatic stress disorder treatment programs

Abstract

Research on the impact of time since trauma (TST) on posttraumatic stress disorder (PTSD) treatment outcomes lacks consensus and has not been examined in cognitive processing therapy (CPT)-based intensive PTSD treatment programs (ITPs). Furthermore, little is known about how TST impacts other trauma-related outcomes, such as depressive symptoms and negative posttrauma cognitions. We examined whether TST predicted severity and changes in PTSD and depressive symptoms and negative posttrauma cognitions, controlling for trauma type (combat or military sexual trauma), age, sex, and race, in two separate samples of veterans with PTSD who completed 2-week (n = 132) or 3-week (n = 407) CPT-based ITPs. In the 3-week sample, PTSD symptom reduction differed based on TST; however, these differences lacked clinical significance, TST x Time R² _b = .002, and were not replicated in the 2-week sample, R² _b < .001. TST did not significantly predict depressive symptoms, R² _b = .005, or negative posttrauma cognition severity or changes, R² _b = .002, in the 3-week sample. In the 2-week sample, linear mixed-effects models indicated that TST also did not significantly predict PTSD or depressive symptoms, R² _b s < .001, or negative posttrauma cognition severity or changes, R² _b s = .002. These findings suggest that TST is not a clinically relevant predictor of PTSD symptoms, depressive symptoms, or negative posttrauma cognitions among individuals engaged in CPT-based ITPs. Future research should investigate the association between TST and trauma-related outcomes in more trauma type- and age-diverse samples within different intensive treatment settings.