One hundred and eight survivors of trauma attending a stress clinic were assessed on measures of coping, personality, control expectancies and psychological distress. The psychometric characteristics of these questionnaires are discussed, and the relationships between them investigated using correlational and regression techniques. Although cross-sectional studies can only be indicative, it would appear that most coping strategies, and particularly escape-avoidance, are consistently associated with high psychological distress, with the exception of positive reappraisal and distancing, which are the only strategies associated with better psychological outcome. It may be that deeply distressed survivors cannot find effective ways of obtaining relief, and therefore report many ways of trying to cope.

Twenty-three patients who had experienced a major stressful event were given a debriefing session followed by eight weekly sessions of imaginal exposure and in vivo exposure. Patients recounted their traumatic experiences aloud, using the first person and the present tense, and included as much detail as possible. This account was audiotaped and patients were asked to listen to the tape between treatment sessions. There were reductions of 42 percent in the Impact of Events Scale (IES), of 61 percent in the General Health Questionnaire (GHQ), of 38 percent in the Symptom Checklist-90 (SCL-90) questionnaire, and of 35 percent in the Clinician Administered Post-Traumatic Stress scale (CAPS), all of which were statistically significant. The number of patients who satisfied the diagnostic criteria for post-traumatic stress disorder was halved.