Personality beliefs, coping strategies and quality of life in a cognitive-behavioral therapy for posttraumatic stress disorder

Introduction. - Studies have shown that, following psychotherapy for posttraumatic stress disorder (PTSD), symptoms and quality of life (QoL) may improve in many patients, but not always to the same extent. Dysfunctional core beliefs, such as personality beliefs (PB), are associated to psychopathology, including PTSD, and could be associated with the types of coping strategies deployed by an individual. Beliefs and coping strategies were also linked to psychotherapeutic outcomes. Objectives. - (1) To examine the associations between baseline PB as well as pre- and post-treatment coping strategies; (2) To investigate the mediation effects between PB and the changes in QoL, through changes in coping strategies in a cognitive-behavioral psychotherapy (CBT). Method. - Seventy-one adults with PTSD participating in a correlational/observational CBT study were assessed for PB before a CBT, as well as for coping strategies and QoL, before and after a CBT. Results. - PB were generally associated with post-treatment distancing coping. Moreover, changes in distancing coping mediated the relationships between avoidant or dependent PB and psychological QoL improvements. Conclusion. - This is the first study to show the relationships between PB and coping strategies in PTSD patients, and that higher avoidant or dependent PB predicts a lower reduction in the use of distancing coping through psychotherapy, which is associated with less improvement in psychological QoL. Future studies are needed to further define the role of these variables and target more precisely factors that may hamper the treatment effects of CBT for PTSD. (C) 2019 Elsevier Masson SAS. All rights reserved.