Cognitive analytic therapy for the treatment of post-traumatic stress disorder: a randomized controlled trial

Abstract

Background

Post-traumatic stress disorder represents a multifaceted clinical entity with a profound impact on mental health. This study was conducted to evaluate the effects of cognitive analytic therapy on the manifestations of post-traumatic stress disorder.

Materials and methods

From May 21, 2023, to July 7, 2023, we conducted a randomized control trial in the outpatient clinic of a psychiatry Hospital. Participants were Iran-Iraq war veterans (N = 40) with a confirmed diagnosis of post-traumatic stress disorder. They were randomly allocated to cognitive analytic therapy and control groups. The primary outcome was re-experiencing, and the secondary outcomes included avoidance, hyperarousal, depression, anxiety, and numbness scores measured by appropriate questionnaires before and after the interventions. The cognitive analytic therapy group received a weekly program totaling 12 sessions of therapy adjunct to pharmacotherapy, each session lasting 90 min, and the control group received only pharmacotherapy.

Results

Within-group analysis showed that cognitive analytic therapy (N = 19) decreased all symptom scores (all p < 0.001), while the control group (N = 20) showed a decrease in hyper-arousal, depression, and anxiety (p < 0.001) scores. Between-group analysis implied that cognitive analytic therapy was more successful than usual pharmacotherapy in decreasing all outcome scores (all p < 0.001)

Conclusion

A 12-session program of cognitive analytic therapy was effective in alleviating re-experiencing, avoidance, hyper-arousal, depression, anxiety, and numbness in post-traumatic stress disorder. It was safe and acceptable by participants reflected by a high retention rate. We recommend the incorporation of cognitive analytic therapy to the treatment of post-traumatic stress disorder.

HIGHLIGHTS

• A 12-session of CAT is effective for treating PTSD.

• The interventions control re-experiencing, avoidance, and hyper-arousal in PTSD.

• Also, they decrease depression, anxiety, and numbness in patients with PTSD.

• Overall, CAT is safe and acceptable to participants.

• Participants’ retention is high for CAT with a minimum dropout.

Keywords:

• Cognitive
• analytic
• post-traumatic
• stress
• PTSD

Author contributions

Tina Karbasi, Morteza Rostaee, Navid Hosseini Arian, and Fateme Rayyat Moeini conceptualized the study and contributed to the clinical interpretation of the results. Seyyedeh Mojgan Ghasemii, Zahra Feiznia, Zhila Alipour Azami, reviewed the literature and participated in the design of the study. Fateme Rayyat Moeini and Seyyedeh Mojgan Ghasemii contributed to study planning and data analysis. Fateme Rayyat Moeini conducted CAT sessions. All the authors participated in drafting or its critically appraisal and approved the final version of this article.

Disclosure statement

No potential competing interest was reported by the authors.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Notes on contributors

Seyedeh Mozhgan Ghasemi

Seyedeh Mozhgan Ghasemi is a clinical psychologist and researcher in a department of clinical psychology. Her main focus is on the treatment of post-traumatic stress disorder, and she is also interested in research design in psychology.

Zahra Feiznia

Zahra Feiznia is a clinical psychologist, interested in the treatment of post-traumatic stress disorder.

Tina Karbasi

Tina Karbasi is a PhD candidate in psychology with a research focus on the etiology of post-traumatic stress disorder.

Morteza Roostaee

Morteza Roostaee is a PhD candidate in clinical psychology interested in the diagnosis and treatment of post-traumatic stress disorder.

Zhila Alipour Azami

Zhila Alipour Azami is a clinical psychologist and researcher in a department of clinical psychology. She has a particular interest in cognitive behavioral therapy.

Navid Hosseini Arian

Navid Hosseini Arian is a PhD candidate in psychology. He is interested in conducting research on cognitive analytic therapy.

Fateme Rayyat Moeini

Fateme Rayyat Moeini is a PhD candidate in clinical psychology. She is a researcher in a department of clinical psychology and a practitioner in cognitive analytic therapy focusing particularly on the treatment of post-traumatic stress disorder. She is interested in research design and data analysis.