Comparison of the processing of positive memories technique and supportive counseling for posttraumatic stress disorder: A randomized controlled trial

Research suggests that positive memory processes influence maintenance, onset, and treatment of posttraumatic stress disorder (PTSD) symptoms. A novel PTSD intervention–Processing of Positive Memories Technique (PPMT)–addresses positive memory processes as an active treatment ingredient. This study compared PPMT to Supportive Counseling (SC) in a randomized controlled trial to examine their comparative effects on PTSD symptom severity and mechanistic targets (affect) underlying treatment effects. Seventy adults with PTSD ( M age =31.31 [ SD =13.20]; 80% female participants) were randomized to five weekly PPMT or SC therapy sessions and were assessed at baseline, each weekly session, and 1-week and 3-month follow-up appointments. Measures included the PTSD Checklist for DSM-5 and Positive and Negative Affect Schedule. Mixed effects models indicated no significant overall differences between treatment groups on PCL-5 score improvement ( p =.477). However, PCL-5 scores decreased significantly in both groups ( ps <.001, d =1.26 for SC, d =1.42 for PPMT). Cross-lag mediation analyses indicated that neither PANAS-Positive ( p =.735) nor PANAS-Negative ( p =.224) scores mediated treatment group differences in PCL-5 scores over time. Post-hoc exploratory moderation analyses indicated that baseline PCL-5 severity moderated results of the primary analysis ( p <.001), with participants having higher baseline PCL-5 scores (>31) showing significantly greater improvement in PCL-5 scores in PPMT than in SC ( p =.028, d =.78); and PANAS-Positive scores significantly mediated treatment group differences in slopes of PCL-5 scores ( p <.05). PPMT did not differ from SC in improving PTSD, although some preliminary evidence suggested that PPMT may be particularly beneficial for individuals with greater baseline PTSD severity, potentially through increasing positive affect. NCT05523453 • RCT compared Processing of Positive Memories Technique (PPMT) to Supportive Counseling (SC) among 70 adults with PTSD. • PTSD severity decreased significantly in both groups, with no significant differences between treatment groups. • Positive and negative affect did not mediate treatment group differences in PTSD severity over time. • Among participants with more baseline PTSD severity, there was greater PTSD improvement in PPMT vs. SC; and positive affect mediated these differences. • By increasing engagement with positive memories/affect, PPMT may be a novel alternative or adjunctive treatment for trauma survivors.