Appraisal-based cognitive bias modification in patients with posttraumatic stress disorder: a randomised clinical trial. Issue 1 (31st December 2019)

• Record Type: Journal Article
• Authors: de Kleine, Rianne A.; Woud, Marcella L.; Ferentzi, Hannah; Hendriks, Gert-Jan; Broekman, Theo G.; Becker, Eni S.; Van Minnen, Agnes
• Is Part Of: European journal of psychotraumatology. Volume 10:Issue 1(2019)
• Publication Date: 2019-12-31
• Subjects: Cognitive bias modification -- appraisals -- bias posttraumatic stress disorder -- randomised clinical trial -- trauma-related cognitions; Modificación de Sesgo Cognitivo -- Valoraciones -- Trastorno de Estrés Postraumático -- ensayo clínico randomizado; 认知偏差校正 -- 评估 -- 创伤后应激障碍 -- 随机临床试验; Post-traumatic stress disorder -- Periodicals; Stress Disorders, Post-Traumatic; Post-traumatic stress disorder; Electronic journals; Periodicals; Periodicals; Fulltext; Internet Resources; Periodicals; 616.8521
• DOI: 10.1080/20008198.2019.1625690
• Languages: English
• ISSNs: 2000-8198

Abstract

ABSTRACT: Background : Negative appraisals of the trauma and its sequelae play a crucial role in the development and maintenance of Posttraumatic Stress Disorder (PTSD). Experimental studies have shown promise in reducing negative appraisal through Cognitive Bias Modification (CBM) training. Objective : To determine whether an online CBM training designed to modify dysfunctional appraisals is successful in reducing appraisal bias in PTSD patients. Method : In this double-blinded 2-arm randomised clinical trial, 107 patients with PTSD were randomly allocated to active ( n = 49) or control online CBM training ( n = 57). Training comprised the completion of four sessions of online CBM training within one week. Change in bias, as measured by a scenario task and questionnaire (i.e. PostTraumatic Cognition Inventory), was the primary outcome. Secondary outcome included change in PTSD symptoms. Assessments took place prior to training, during training sessions, post-training and at 1- and 6-month follow-up. Results : Intent-to-treat analysis indicated that there was no interaction effect of condition by time. Regardless of training condition, participants showed a small to moderate decline in appraisal bias and PTSD symptoms from pre- to post-training. In both conditions, bias change during training sessions was related to decline in PTSD symptomatology following training. No moderators of outcome were found. Conclusions : There was no evidence that active training was more effective than control training in reducing dysfunctional appraisals. In both conditions, participants showed a decline in dysfunctional appraisals and PTSD symptoms following training. Importantly, bias reduction during training was related to PTSD symptom decline following training. Explanations and future research directions are discussed. HIGHLIGHTS: CBM training aimed at reducing negative appraisals yielded promising findings in clinical analogue samples In this RCT, active CBM training did not lead to a greater decline in dysfunctional appraisals than control training. This study highlights the impact of appraisal on PTSD symptoms: irrespective of training condition, bias reduction during training was related to lower PTSD symptoms following training. Follow-up studies are needed to further explore the possible clinical efficacy of CBM interventions in PTSD.