The Effect of Sleep Disorders, Sedating Medications, and Depression on Cognitive Processing Therapy Outcomes: A Fuzzy Set Qualitative Comparative Analysis.
AuthorHaynes, Patricia L
Emert, Sarah E
AffiliationUniv Arizona, Hlth Promot Sci
Univ Arizona, Dept Med
MetadataShow full item record
CitationHaynes, P. L., Emert, S. E., Epstein, D. , Perkins, S. , Parthasarathy, S. and Wilcox, J. (2017), The Effect of Sleep Disorders, Sedating Medications, and Depression on Cognitive Processing Therapy Outcomes: A Fuzzy Set Qualitative Comparative Analysis. JOURNAL OF TRAUMATIC STRESS, 30: 635-645. doi:10.1002/jts.22233
JournalJOURNAL OF TRAUMATIC STRESS
RightsPublished 2017. This article is a U.S. Government work and is in the public domain in the USA
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at email@example.com.
AbstractCognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) is an effortful process requiring engagement in cognitive restructuring. Sleep disorders may lead to avoidance of effortful tasks and cognitive performance deficits. We explored whether sleep disorders, as assessed by polysomnography, were consistently associated with treatment response in combination with other factors. This study included 32 U.S. veterans who were examined both before and after CPT for combat-related PTSD. We employed a novel, case-comparative technique, fuzzy set qualitative comparative analysis (fsQCA), to identify combinations of fuzzy and crisp factors (recipes) that achieve a clinically significant outcome. Approximately one-quarter of cases experiencing clinically significant change were either (a) Vietnam era veterans without sedating medications, moderate sleep disordered breathing, and severe depression; or (b) non-Vietnam era veterans with sedating medications and without severe periodic limb movements (or significant periodic limb movement arousals). Recipes involving the absence of the relevant sleep disorder were associated with the highest coverage values. These results using fsQCA (a) provide valuable information about the heterogeneity of CPT response and (b) suggest that sleep disorders are important factors to consider in theoretical discussions of who responds to CPT for PTSD.
Note24 month embargo; published online: 21 November 2017
VersionFinal accepted manuscript
SponsorsU.S. Army Medical Research and Materiel Command Award [W81XWH-10-1-0745]