PTSD Treatment Response and Quality of Life in Women With Childhood Trauma Histories

Objective: Childhood trauma is associated with greater psychological problems and poorer quality of life (QOL). This study evaluates the effect of multiple types of childhood trauma on posttraumatic stress disorder (PTSD) and QOL following cognitive processing therapy (CPT). Understanding how the breadth of traumatic experiences in childhood can influence psychosocial treatment outcomes may help to identify the unique needs of this population. Method: This secondary data analysis of a randomized controlled trial delivering CPT to civilian (n = 105) and veteran women (n = 21) with PTSD used linear regressions to examine relationships between the number of unique types of childhood trauma, PTSD, and QOL before and after treatment. Models controlled for demographic information, adult trauma, and pretreatment PTSD, depression, and QOL scores. Results: More types of childhood trauma predicted pretreatment PTSD symptoms (B = 1.98, p=.02) but not QOL (B = -.018, p = .18). Significant reductions in Clinician-Administered PTSD Scale for DSM-IV-TR score, t(302) = 10.32, p = .001, and QOL, t(309) = -4.06, p < .001, were reported after treatment; number of traumatic event types was not predictive of QOL change (B = .01, p = .957). Women with more types of trauma reported significantly less PTSD symptom reduction when compared with those with one type (B = 3.12, p = .042). Conclusion: Women who experienced a broader range of childhood trauma may experience diminished PTSD symptom reduction following CPT in comparison with women with less exposure. On average, all women, regardless of trauma history, reported small improvements in QOL. Clinical considerations are discussed. Clinical Impact Statement The current study highlights the importance of looking beyond posttraumatic stress disorder symptom reduction when assessing patient outcomes following trauma-focused treatment. Additionally, this study underscores the value of examining quality of life to better address the unique health care needs of women with childhood trauma histories.