Patterns of Treatment Disengagement and Personality Traits Associated With Posttraumatic Stress Disorder in Recent‐Era U.S. Veterans Receiving Cognitive Processing Therapy

Low treatment engagement is a barrier to implementation of empirically supported treatments for posttraumatic stress disorder (PTSD) among veterans. Understanding personality traits that predict dropout may help focus attempts to improve engagement. The current study included 90 veterans who served in recent conflicts in Iraq and/or Afghanistan and participated in a trial of cognitive processing therapy for PTSD. Goals were to characterize (a) personality correlates of PTSD, (b) patterns of engagement (i.e., attendance and homework completion), and (c) personality correlates of reduced engagement. Higher levels of PTSD symptoms were associated with a range of characteristics, including affective lability, r = .44 p < .001; anxiety, r = .38, p < .001; identity problems, r = .57, p < .001; intimacy problems, r = .34, p = .001; low affiliation, r = .33, p = .002; oppositionality, r = .36, p = .001; restricted expression, r = .35, p = .001; and suspiciousness, r = .50, p < .001. Notably, veterans with worse PTSD symptoms endorsed more cognitive dysregulation, r = .40, p < .001; and less insecure attachment, r = .14, p = .190, than expected. Only 52.2% of veterans completed the 12‐session course of treatment and 31.0% of participants completed fewer than six sessions. Personality traits did not predict attendance or homework completion. Disengagement continues to be a significant issue in trauma‐focused treatment for veterans with PTSD. Understanding veteran‐level factors, such as personality traits, may be useful considerations for future research seeking to understand and improve engagement. Resumen Spanish s by Asociación Chilena de Estrés Traumático (ACET) Patrones de desconexión del tratamiento y rasgos de personalidad asociados con el trastorno de estrés postraumático en Recientes Veteranos Estadounidenses que reciben terapia de procesamiento cognitivo DESCONEXIÓN DEL TRATAMIENTO Y PERSONALIDAD EN VETERANOS El bajo compromiso con el tratamiento es una barrera para la implementación de tratamientos con apoyo empírico para el trastorno de estrés postraumático (TEPT) entre los veteranos. Comprender los rasgos de personalidad que predicen el abandono puede ayudar a enfocar los intentos de mejorar el compromiso con el tratamiento en esta población. El estudio actual incluyó una muestra de 90 veteranos que habían servido en conflictos recientes en Irak y / o Afganistán y que estaban inscritos en el ensayo de terapia de procesamiento cognitivo para el TEPT. Los