In this study, we examined processes of change in trauma-focused cognitive behavioral therapy (TF-CBT) delivered to a community sample of 81 youths. Emotional processing theory (EPT) is used as an organizational framework. EPT highlights activating and changing pathological trauma-related responses and increasing adaptive responses across cognitive, emotional, behavioral, and physiological domains. We coded sessions during the trauma-narration and -processing phase of TF-CBT to examine the extent to which pathological and adaptive trauma-related responses were activated across domains. Higher scores indicate that more domains (range = 0–4) were activated at a threshold of moderate to high intensity. Curvilinear change (inverted U, increase then decrease) in multimodal negative response scores across sessions predicted improvement in internalizing symptoms and symptoms of posttraumatic stress disorder after treatment. Linear increases in multimodal positive responses predicted improvement in externalizing symptoms. Findings suggest value in activating and changing both pathological and adaptive trauma responses across multiple domains and examining nonlinear patterns of change.

在这项研究中，我们检查了以创伤为重点的认知行为疗法（TF-CBT）的变化过程，该变化过程已交付给81位青年社区样本。情感处理理论（EPT）被用作组织框架。EPT强调了在认知，情感，行为和生理领域中激活和改变与病理性创伤相关的反应，以及增加适应性反应。我们在TF-CBT的创伤叙述和处理阶段对会议进行编码，以检查跨域激活病理性和适应性创伤相关反应的程度。较高的分数表明，在中等强度到高强度的阈值下激活了更多域（范围= 0–4）。曲线变化（倒U，在整个疗程中，多式联运的负面反应评分会增加，并预测内化症状和治疗后创伤后应激障碍的症状会有所改善。多峰阳性反应的线性增加预示着症状的改善。研究结果表明，在跨多个领域激活和改变病理和适应性创伤反应以及研究非线性变化模式方面具有价值。