Pre-Treatment Resilience as a Predictor of Veterans' Post-Traumatic Stress Disorder Symptom Outcomes Immediately and Up To 12-Months Following Intensive Cognitive Processing Therapy.

OBJECTIVE

Resilience is associated with lower post-traumatic stress disorder (PTSD) severity and may play a beneficial role in PTSD treatment. The present study explored if pre-treatment resilience and changes in resilience during intensive treatment for PTSD were associated with PTSD and depression symptom change among veterans during and up to a year after treatment.

METHODS

A total of 727 veterans (age: M = 45.1 years, SD = 10.3) participated in a 2-week Cognitive Processing Therapy (CPT)-based Intensive PTSD Treatment Program (ITP). Resilience was assessed at the start and end of the program, while PTSD and depression were assessed every other day of the program and 3-, 6-, and 12-months post-treatment.

RESULTS

Veterans with higher pre-treatment resilience tended to have lower PTSD (b = -0.24, p < 0.001, R2 = 0.04) and depression severity (b = -0.10, p < 0.001, R2 = 0.07) throughout the ITP. Pre-treatment resilience was not associated with differing treatment trajectories for PTSD (b = -0.01, p = 0.492) or depression (b = -0.01, p = 0.184). Improvements in resilience from the beginning to end of treatment were associated with improvements in PTSD (b = -0.24, p < 0.001, R2 = 0.02) and depression symptoms (b = -0.10, p < 0.001, R2 = 0.01). Pre-treatment resilience was associated with PTSD severity 3- and 12-months following treatment, and with depression severity 3- and 6-months post-treatment. Changes in resilience during treatment were associated with PTSD severity up to 1 year post-treatment, and up to 3 months for depression severity.

CONCLUSION

The findings highlight that patients may experience similarly beneficial treatment trajectories regardless of their pre-treatment resilience. This may offer hope to patients with lower resilience that they can still achieve meaningful PTSD and depression symptom reductions.