The role of cognitions and emotional processes in PTSD severity among young people seeking treatment for PTSD and substance use
Annabel Hughes, Katherine L. Mills, Vanessa Cobham, Joanne Cassar, Sudie E. Back, Sarah Bendall, Ashling Isik, Natalie Peach, Maree Teesson, Ivana Kihas, Kathleen Brady, Olivia Schollar-Root, Louise Bezzina, Emma L. Barrett, Bronwyn Milne, Sean PerrinPurpose
Cognitive models emphasise trauma-related appraisals in relation to post-traumatic stress symptoms. Cognitive-emotional processes may also shape symptom presentation, yet these processes are rarely examined together. This study aims to address these gaps by examining the associations between overall and cluster-specific PTSD severity and the severity of trauma-related beliefs (i.e. negative post-traumatic cognitions about the self, others and the world) and transdiagnostic processes (perseverative thinking, emotion regulation and distress tolerance) in treatment-seeking youth.
Design/methodology/approach
Data were drawn from 55 adolescents and young adults (M age = 19.49, SD = 3.27; 38 female) enrolled in a randomised controlled trial evaluating an integrated treatment for co-occurring PTSD and substance use. Participants completed baseline assessments of trauma-related beliefs, perseverative thinking, distress tolerance, emotion regulation and PTSD symptom severity.
Findings
PTSD severity was strongly associated with the severity of trauma-related cognitions. Beliefs about a fragile self and perceptions of permanent disturbing change evidence the strongest associations with overall PTSD severity, and re-experiencing, negative cognitions/mood and hyperarousal. No variables were significantly associated with avoidance. Rumination, emotion regulation and distress tolerance were not significantly associated with PTSD severity once trauma-related cognitions were included in the models. These findings highlight associations between maladaptive trauma-related beliefs about the self and the world and PTSD severity.
Originality/value
To the best of the authors’ knowledge, this study is among the first to examine trauma-related cognitions and cognitive-emotional processes in youth with PTSD and substance use. It advances existing research by examining their associations with overall and cluster-specific PTSD severity and highlights the need to examine temporal and mediating pathways in future work.