Adaptive Cognitive Strategies Moderate the Association Between Brooding and PTSD Symptoms

Abstract


Introduction: Brooding (i.e., cognitive style of responding to distress by repetitively and passively focusing on symptoms, causes, and consequences of symptoms) is a maladaptive process by which some trauma-exposed individuals make sense of their traumatic experiences and related distress. Brooding is a strong predictor of PTSD symptom severity; however, it is possible that engaging in adaptive cognitive strategies during ruminative thinking dampens the impact of brooding on PTSD symptoms. Refocusing on planning is an adaptive cognitive strategy by which people plan how to cope with their situation and positive reappraisal is a strategy where people think about the positive aspects of an event. The present study seeks to examine whether adaptive cognitive coping strategies, such as refocus on planning and positive reappraisal, moderate the association between brooding and PTSD symptom severity.

Methods: Participants included 217 trauma-exposed community members (45.62% diagnosed with PTSD). Participants completed the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), Cognitive Emotion Regulation Questionnaire, and Response Styles Questionnaire (brooding subscale).

Results: After controlling for PTSD diagnostic status, use of adaptive refocus on planning strategies (B = -0.08, SE = 0.03), F(1,210) = 6.07, p = .015, and positive reappraisal strategies (B = -0.06, SE = 0.03), F(1,211) = 5.37, p = .021, moderated the relation between brooding and PTSD symptom severity (CAPS-5 total score), such that brooding was significantly associated with PTSD symptom severity for individuals at low or average levels of refocus on planning or positive reappraisal strategies, but was not significantly associated with PTSD symptom severity at high levels of these strategies.

Conclusions: The association between brooding and PTSD symptom severity is strongest for people with low or average engagement with adaptive refocus on planning and positive reappraisal strategies. Clinical interventions focused on improving cognitive emotion regulation coping strategies among trauma-exposed populations may weaken the relation between brooding and PTSD symptom severity.