@2024 Afarand., IRAN
ISSN: 2008-2630 Iranian Journal of War & Public Health 2015;7(1):43-48
ISSN: 2008-2630 Iranian Journal of War & Public Health 2015;7(1):43-48
Effect of Cognitive Processing Therapy on Cardiovascular Biomarkers of Veterans with Post- Traumatic Stress Disorder
ARTICLE INFO
Article Type
Original ResearchAuthors
Aghayousefi A. (1 )Amirpour B. (* )
(* ) Psychology Department, Psychology Faculty, Tehran Branch, Payame- Noor University, Tehran, Iran
(1 ) Psychology Department, Psychology Faculty, Tehran Branch, Payame- Noor University, Tehran, Iran
Correspondence
Address: Graduate Education Center of Payam-e-Noor University, Safa Alley, Shahnaz Alley, Haj Mahmoud Noorian Street, North Dibaji Street, Tehran, Iran. Postal Code: 19536335Phone: +98 8348233449
Fax: +98 8348227173
borzooamirpour@gmail.com
Article History
Received: November 10, 2014Accepted: December 24, 2014
ePublished: February 19, 2015
ABSTRACT
Aims
In terms of epidemiology, posttraumatic stress disorder is considered as the fourth
most common psychiatric disorder. This study aimed to study the use of cardiovascular
biomarkers (systolic and diastolic blood pressure, heart rate and body temperature) in war
veterans with posttraumatic stress disorder.
Materials & Methods This quasi-experimental study with pretest-posttest and control group was done on Iran-Iraq war men veterans living in Kermanshah province in 2014 with posttraumatic stress disorder. 24 patients were selected by convenience sampling and were placed into experimental groups were waiting list. Data were collected by the Post Traumatic Stress Disorder Checklist-Military (PCL-M). For the experimental group, 12 weeks cognitive processing therapy was applied for 60 minutes each session. Data were analyzed with IBM SPSS 22 statistical software and univariate analysis of covariance.
Findings 56% of systolic blood pressure reduction, 62% of diastolic blood pressure reduction, 80% of heart rate reduction and 97% of body temperature reduction in experimental group at the post-test was explained by cognitive processing therapy.
Conclusion Due to the negative consequences of posttraumatic stress disorder on cardiovascular health in patients, who suffer from this disorder, cognitive processing therapy can be effective in improving symptoms of cardiovascular hyperarousal indices.
Materials & Methods This quasi-experimental study with pretest-posttest and control group was done on Iran-Iraq war men veterans living in Kermanshah province in 2014 with posttraumatic stress disorder. 24 patients were selected by convenience sampling and were placed into experimental groups were waiting list. Data were collected by the Post Traumatic Stress Disorder Checklist-Military (PCL-M). For the experimental group, 12 weeks cognitive processing therapy was applied for 60 minutes each session. Data were analyzed with IBM SPSS 22 statistical software and univariate analysis of covariance.
Findings 56% of systolic blood pressure reduction, 62% of diastolic blood pressure reduction, 80% of heart rate reduction and 97% of body temperature reduction in experimental group at the post-test was explained by cognitive processing therapy.
Conclusion Due to the negative consequences of posttraumatic stress disorder on cardiovascular health in patients, who suffer from this disorder, cognitive processing therapy can be effective in improving symptoms of cardiovascular hyperarousal indices.
Keywords:
Biological Markers,
Cardiovascular System,
Behavior Therapy,
Stress Disorders, Post-Traumatic,
CITATION LINKS
[1]American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Washington, DC: American Psychiatric Publishing; 2013.
[2]Nagpal ML, Gleichauf K, Ginsberg JP. Meta-analysis of heart rate variability as a psychophysiological indicator of posttraumatic stress disorder. J Trauma Treat. 2013;3(1):1-8.
[3]Kimbrell T, Pyne JM, Kunik ME, Magruder KM, Petersen NJ, Yu HJ, et al. The impact of Purple Heart commendation and PTSD on mortality rates in older veterans. Depress Anxiety. 2011;28(12):1086-90.
[4]Cesur R, Sabia JJ, Tekin E. The psychological costs of war: Military combat and mental health. J Health Econ. 2013;32(1):51-65.
[5]Forneris CA, Butterfield MI, Bosworth HB. Physiological arousal among women veterans with and without posttraumatic stress disorder. Mil Med. 2004;169(4):307-12.
[6]Khazaie H, Saidi MR, Sepehry AA, Knight DC, Ahmadi M, Najafi F, et al. Abnormal ECG patterns in chronic post-war PTSD patients: a pilot study. Int J Behav Med. 2013;20(1):1-6.
[7]Blechert J, Michael T, Grossman P, LajtmanM, & et al. Autonomic and respiratory characteristics of posttraumatic stress disorder and panic disorder. Psychosom Med. 2007;69(9):935-43.
[8]Kibler JL, Joshi K, Mindy M. Hypertension in relation to posttraumatic stress disorder and depression in the US National Comorbidity Survey. Behav Med. 2009;34(4):125-131.
[9]Juster RP, McEwen BS, Lupien SJ. Allostatic load biomarkers of chronic stress and impact on health and cognition. Neurosci Biobehav Rev. 2010;35(1):2-16.
[10]Glover DA, Stuber M, Poland RE. Allostatic load in women with and without PTSD symptoms. Psychiatry. 2006;69(3)191-203.
[11]Strimbu K, Taval JA. What are Biomarkers?. Curr Opin HIV AIDS. 2010;5(6):463-6.
[12]Tarkhan M, Safarinia M, Koshsima P. Effectiveness of group stress inoculation training on the systolic and diastolic blood pressure and life quality of hypertension in women. Health Psychol. 2012;1(1):46-58. [Persian]
[13]Norte CE, Souza GG, Vilete L, Marques-Portella C, Coutinho ES, Figueira I, et al. They know their trauma by heart: An assessment of psychophysiological failure to recover in PTSD. J Affect Disord. 2013;150(1):136-41.
[14]Morris MC, Rao U. Psychobiology of PTSD in the acute aftermath of trauma: Integrating research on coping, HPA function and sympathetic nervous system activity. Asian J Psychiatr. 2013;6(1):3-21.
[15]Greenawalt DS, Copeland LA, MacCarthy AA, Sun FF, Zeber JE. Posttraumatic stress disorder and odds of major invasive procedures among U.S. Veterans Affairs patients. J Psychosom Res. 2013;75(4):386-93.
[16]Vrana SR, Hughes JW, Dennis MF, Calhoun PS, Beckham JC. Effects of posttraumatic stress disorder status and covert hostility on cardiovascular responses to relived anger in women with and without PTSD. Biol Psychol. 2009;82(3):274-80.
[17]Hall KS, Beckham JC, Bosworth HB, Sloane R, Pieper CF, Morey MC. PTSD is negatively associated with physical performance and physical function in older overweight military Veterans. J Rehabil Res Dev. 2014;51(2):285-95.
[18]Williams M, Jayawickreme N, Sposato R, Foa EB. Race-specific associations between trauma cognitions and symptoms of alcohol dependence in individuals with morbid PTSD and alcohol dependence. Addict Behav. 2012;37(1):47-52.
[19]Dekel S, Peleg T, Solomon Z. The relationship of PTSD to negative cognitions: a 17-year longitudinal study. Psychiatry. 2013;76(3):241-55.
[20]Castillo DT, Lacefield K. de Baca JC, Blankenship A, Qualls C. Effectiveness of group-delivered cognitive therapy and treatment length in women veterans with PTSD. Behav Sci. 2014;4(1):31-41.
[21]Gallagher MW, Resick PA. Mechanisms of change in cognitive processing therapy and prolonged exposure therapy for PTSD: Preliminary evidence for the differential effects of hopelessness and habituation. Cogn Ther Res. 2012;36(6):750-5.
[22]Macdonald A, Monson CM, Doron-Lamarca S, Resick PA, Palfai TP. Identifying patterns of symptom change during a randomized controlled trial of cognitive processing therapy for military-related posttraumatic stress disorder. J Trauma Stress. 2011;24(3):268-76.
[23]Sobel AA, Resick PA, Rabalais AE. The effect of cognitive processing therapy on cognitions: impact statement coding. J Trauma Stress. 2009;22(3):205-11.
[24]Narimani M, Basharpoor S, Gamarigive H, Abolgasemi, A. Impact of cognitive processing and holographic reprocessing on posttraumatic symptoms improvement amongst Iranian students. Adv Cogn Sci. 2013;15(2):50-62. [Persian]
[25]Rosner R, König HH, Neuner F, Schmidt U, Steil R. Developmentally adapted cognitive processing therapy for adolescents and young adults with PTSD symptoms after physical and sexual abuse: study protocol for a randomized controlled trial. Trials. 2014;15:195.
[26]Morland LA, Hynes AK, Mackintosh MA, Resick PA, Chard KM. Group cognitive processing therapy delivered to veterans via telehealth: a pilot cohort. J Trauma Stress. 2011;24(4):465-9.
[27]Surís A, Link-Malcolm J, Chard K, Ahn C, North C. A randomized clinical trial of cognitive processing therapy for veterans with PTSD related to military sexual trauma. J Trauma Stress. 2013;26(1):28-37.
[28]Davis MT, Witte TK, Weathers FW. Posttraumatic stress disorder and suicidal ideation: The role of specific symptoms within the framework of the interpersonal-psychological theory of suicide. Psychol Trauma 2014; 6(6): 610-618.
[29]Chalmers JA, Quintana DS, Anne Aboott MJ, Kemp AH. Anxiety disorders are associated with reduced heart rate variability: a meta-analysis. Front Psy. 2014;5:80.
[30]Free ML. Cognitive therapy in groups: guidelines and resources for practice.2th ed. New York: Wiley; 2007.
[31]Kip KE, Elk CA, Sullivan KL, Kadel R, Lengacher CA, Long CJ, et al. Brief treatment of symptoms of post-traumatic stress disorder (PTSD) by use of accelerated resolution therapy (ART). Behav Sci. 2012;2(2):115-34.
[2]Nagpal ML, Gleichauf K, Ginsberg JP. Meta-analysis of heart rate variability as a psychophysiological indicator of posttraumatic stress disorder. J Trauma Treat. 2013;3(1):1-8.
[3]Kimbrell T, Pyne JM, Kunik ME, Magruder KM, Petersen NJ, Yu HJ, et al. The impact of Purple Heart commendation and PTSD on mortality rates in older veterans. Depress Anxiety. 2011;28(12):1086-90.
[4]Cesur R, Sabia JJ, Tekin E. The psychological costs of war: Military combat and mental health. J Health Econ. 2013;32(1):51-65.
[5]Forneris CA, Butterfield MI, Bosworth HB. Physiological arousal among women veterans with and without posttraumatic stress disorder. Mil Med. 2004;169(4):307-12.
[6]Khazaie H, Saidi MR, Sepehry AA, Knight DC, Ahmadi M, Najafi F, et al. Abnormal ECG patterns in chronic post-war PTSD patients: a pilot study. Int J Behav Med. 2013;20(1):1-6.
[7]Blechert J, Michael T, Grossman P, LajtmanM, & et al. Autonomic and respiratory characteristics of posttraumatic stress disorder and panic disorder. Psychosom Med. 2007;69(9):935-43.
[8]Kibler JL, Joshi K, Mindy M. Hypertension in relation to posttraumatic stress disorder and depression in the US National Comorbidity Survey. Behav Med. 2009;34(4):125-131.
[9]Juster RP, McEwen BS, Lupien SJ. Allostatic load biomarkers of chronic stress and impact on health and cognition. Neurosci Biobehav Rev. 2010;35(1):2-16.
[10]Glover DA, Stuber M, Poland RE. Allostatic load in women with and without PTSD symptoms. Psychiatry. 2006;69(3)191-203.
[11]Strimbu K, Taval JA. What are Biomarkers?. Curr Opin HIV AIDS. 2010;5(6):463-6.
[12]Tarkhan M, Safarinia M, Koshsima P. Effectiveness of group stress inoculation training on the systolic and diastolic blood pressure and life quality of hypertension in women. Health Psychol. 2012;1(1):46-58. [Persian]
[13]Norte CE, Souza GG, Vilete L, Marques-Portella C, Coutinho ES, Figueira I, et al. They know their trauma by heart: An assessment of psychophysiological failure to recover in PTSD. J Affect Disord. 2013;150(1):136-41.
[14]Morris MC, Rao U. Psychobiology of PTSD in the acute aftermath of trauma: Integrating research on coping, HPA function and sympathetic nervous system activity. Asian J Psychiatr. 2013;6(1):3-21.
[15]Greenawalt DS, Copeland LA, MacCarthy AA, Sun FF, Zeber JE. Posttraumatic stress disorder and odds of major invasive procedures among U.S. Veterans Affairs patients. J Psychosom Res. 2013;75(4):386-93.
[16]Vrana SR, Hughes JW, Dennis MF, Calhoun PS, Beckham JC. Effects of posttraumatic stress disorder status and covert hostility on cardiovascular responses to relived anger in women with and without PTSD. Biol Psychol. 2009;82(3):274-80.
[17]Hall KS, Beckham JC, Bosworth HB, Sloane R, Pieper CF, Morey MC. PTSD is negatively associated with physical performance and physical function in older overweight military Veterans. J Rehabil Res Dev. 2014;51(2):285-95.
[18]Williams M, Jayawickreme N, Sposato R, Foa EB. Race-specific associations between trauma cognitions and symptoms of alcohol dependence in individuals with morbid PTSD and alcohol dependence. Addict Behav. 2012;37(1):47-52.
[19]Dekel S, Peleg T, Solomon Z. The relationship of PTSD to negative cognitions: a 17-year longitudinal study. Psychiatry. 2013;76(3):241-55.
[20]Castillo DT, Lacefield K. de Baca JC, Blankenship A, Qualls C. Effectiveness of group-delivered cognitive therapy and treatment length in women veterans with PTSD. Behav Sci. 2014;4(1):31-41.
[21]Gallagher MW, Resick PA. Mechanisms of change in cognitive processing therapy and prolonged exposure therapy for PTSD: Preliminary evidence for the differential effects of hopelessness and habituation. Cogn Ther Res. 2012;36(6):750-5.
[22]Macdonald A, Monson CM, Doron-Lamarca S, Resick PA, Palfai TP. Identifying patterns of symptom change during a randomized controlled trial of cognitive processing therapy for military-related posttraumatic stress disorder. J Trauma Stress. 2011;24(3):268-76.
[23]Sobel AA, Resick PA, Rabalais AE. The effect of cognitive processing therapy on cognitions: impact statement coding. J Trauma Stress. 2009;22(3):205-11.
[24]Narimani M, Basharpoor S, Gamarigive H, Abolgasemi, A. Impact of cognitive processing and holographic reprocessing on posttraumatic symptoms improvement amongst Iranian students. Adv Cogn Sci. 2013;15(2):50-62. [Persian]
[25]Rosner R, König HH, Neuner F, Schmidt U, Steil R. Developmentally adapted cognitive processing therapy for adolescents and young adults with PTSD symptoms after physical and sexual abuse: study protocol for a randomized controlled trial. Trials. 2014;15:195.
[26]Morland LA, Hynes AK, Mackintosh MA, Resick PA, Chard KM. Group cognitive processing therapy delivered to veterans via telehealth: a pilot cohort. J Trauma Stress. 2011;24(4):465-9.
[27]Surís A, Link-Malcolm J, Chard K, Ahn C, North C. A randomized clinical trial of cognitive processing therapy for veterans with PTSD related to military sexual trauma. J Trauma Stress. 2013;26(1):28-37.
[28]Davis MT, Witte TK, Weathers FW. Posttraumatic stress disorder and suicidal ideation: The role of specific symptoms within the framework of the interpersonal-psychological theory of suicide. Psychol Trauma 2014; 6(6): 610-618.
[29]Chalmers JA, Quintana DS, Anne Aboott MJ, Kemp AH. Anxiety disorders are associated with reduced heart rate variability: a meta-analysis. Front Psy. 2014;5:80.
[30]Free ML. Cognitive therapy in groups: guidelines and resources for practice.2th ed. New York: Wiley; 2007.
[31]Kip KE, Elk CA, Sullivan KL, Kadel R, Lengacher CA, Long CJ, et al. Brief treatment of symptoms of post-traumatic stress disorder (PTSD) by use of accelerated resolution therapy (ART). Behav Sci. 2012;2(2):115-34.