TY - JOUR
AU - N. Park
AU - J. Rouvere
AU - E. Chase
AU - B. E. Blanchard
AU - D. L. Kaysen
AU - R. C. Hendrickson
AU - J. C. Fortney
AU - J. M. Cerimele
A1 - 
AB - Evidence describing the association between sleep quality and trauma-focused therapy is mixed. This secondary analysis of a primary care sample examined whether (a) baseline sleep quality moderated posttraumatic stress disorder (PTSD) symptom severity over time across groups receiving different doses of cognitive processing therapy (CPT) and (b) sleep quality improved over time with CPT. Participants were 227 adults who screened positive for PTSD and were participating in a clinical trial comparing two models of PTSD treatment delivery in primary care. The Pittsburgh Sleep Quality Index (PSQI) and PTSD Checklist for DSM-5 (PCL-5) were used to assess sleep disturbance and PTSD symptom severity, respectively. Multiple linear regression was used to assess whether baseline PSQI scores moderated 12-month PCL-5 scores across CPT dosage groups (0 sessions: 51.1%, 1-7 sessions: 31.7%; ≥ 8 sessions [adequate dose]: 17.2%) and whether PSQI scores differed by group at 12-month follow-up. Post hoc analyses examined changes in PCL-5 sleep disturbance items. Baseline sleep disturbance did not moderate the effect of CPT on PTSD severity among participants with an adequate CPT dose, p > .112. Sleep quality improved with adequate dose, B  = -2.63, SE = 0.75, p < .001. Differences in change scores across groups for PCL-5 Item 2, F(2, 435) = 11.34, and Item 20, H(2) = 32.04, indicated that participants with an adequate CPT dose had greater reductions in trauma-related sleep symptoms than those who received 0-7 sessions, ps < .001. Residual post-CPT sleep impairment despite adequate PTSD improvement warrants further interventions.
AD - Department of Neurology (Sleep Medicine), University of California San Francisco, San Francisco, California, USA.; Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA.; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA.; VISN 20 Northwest Mental Illness Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, Washington, USA.; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
AN - 39935094
BT - J Trauma Stress
C5 - Healthcare Disparities
CP - 3
DA - Jun
DO - 10.1002/jts.23132
DP - NLM
ET - 20250211
IS - 3
JF - J Trauma Stress
LA - eng
N2 - Evidence describing the association between sleep quality and trauma-focused therapy is mixed. This secondary analysis of a primary care sample examined whether (a) baseline sleep quality moderated posttraumatic stress disorder (PTSD) symptom severity over time across groups receiving different doses of cognitive processing therapy (CPT) and (b) sleep quality improved over time with CPT. Participants were 227 adults who screened positive for PTSD and were participating in a clinical trial comparing two models of PTSD treatment delivery in primary care. The Pittsburgh Sleep Quality Index (PSQI) and PTSD Checklist for DSM-5 (PCL-5) were used to assess sleep disturbance and PTSD symptom severity, respectively. Multiple linear regression was used to assess whether baseline PSQI scores moderated 12-month PCL-5 scores across CPT dosage groups (0 sessions: 51.1%, 1-7 sessions: 31.7%; ≥ 8 sessions [adequate dose]: 17.2%) and whether PSQI scores differed by group at 12-month follow-up. Post hoc analyses examined changes in PCL-5 sleep disturbance items. Baseline sleep disturbance did not moderate the effect of CPT on PTSD severity among participants with an adequate CPT dose, p > .112. Sleep quality improved with adequate dose, B  = -2.63, SE = 0.75, p < .001. Differences in change scores across groups for PCL-5 Item 2, F(2, 435) = 11.34, and Item 20, H(2) = 32.04, indicated that participants with an adequate CPT dose had greater reductions in trauma-related sleep symptoms than those who received 0-7 sessions, ps < .001. Residual post-CPT sleep impairment despite adequate PTSD improvement warrants further interventions.
PY - 2025
SN - 0894-9867 (Print); 0894-9867
SP - 376
EP - 386+
ST - Associations among sleep quality, cognitive processing therapy, and posttraumatic stress disorder symptoms in a primary care setting
T1 - Associations among sleep quality, cognitive processing therapy, and posttraumatic stress disorder symptoms in a primary care setting
T2 - J Trauma Stress
TI - Associations among sleep quality, cognitive processing therapy, and posttraumatic stress disorder symptoms in a primary care setting
U1 - Healthcare Disparities
U3 - 10.1002/jts.23132
VL - 38
VO - 0894-9867 (Print); 0894-9867
Y1 - 2025
ER -