This study investigated the extent to which providing cognitive restructuring (CR) with prolonged imaginal exposure (IE) would lead to greater symptom reduction than providing IE alone for participants with posttraumatic stress disorder (PTSD). Fifty-eight civilian survivors of trauma with PTSD were randomly allocated to IE/CR, IE, or supportive counseling (SC). Treatment involved 8 individual weekly sessions with considerable homework. Independent assessments were conducted pretreatment, posttreatment, and at 6-month follow-up. IE/CR and IE resulted in reduced PTSD and depression compared with SC at posttreatment and follow-up. Further, IE/CR participants had greater reductions in PTSD and maladaptive cognitive styles than IE participants at follow-up. These findings suggest that providing CR in combination with IE may enhance treatment gains.

Families of 54 behaviorally disturbed preschool-aged children (3 to 5 years) were randomly assigned to 1 of 3 treatment conditions: standard parent-child interaction therapy (PCIT; STD); modified PCIT that used didactic videotapes, telephone consultations, and face-to-face sessions to abbreviate treatment; and a no-treatment waitlist control group (WL). Twenty-one nondisturbed preschoolers were recruited as a social validation comparison condition. Posttreatment assessment indicated significant differences in parent-reported externalizing behavior in children, and parental stress and discipline practices from both treatment groups on most measures compared with the WL group. Clinical significance testing suggested a superior effect for the STD immediately after intervention, but by 6-month follow-up, the two groups were comparable. The findings indicate that abbreviated PCIT may be of benefit for families with young conduct problem children.

The CPTCI is a reliable and valid measure that is not specific to the type of trauma exposure, and shows considerable promise as a research and clinical tool. The structure of this measure suggests that appraisals concerning the more abstract consequences of a trauma, as well as physical threat and vulnerability, are pertinent factors in trauma-exposed children and adolescents, even prepubescent children.

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Background and methods-Factors contributing to posttraumatic stress disorder (PTSD) and comorbid major depression (MDD) were investigated among female victims of intimate partner violence (IPV).Results-High levels of PTSD (75% of the sample) and MDD (54% of the sample) were observed. Individuals with both PTSD and MDD reported significantly greater levels of PTSD and depression symptoms than individuals with either PTSD alone or without major psychopathology. Individuals with comorbid PTSD and MDD had more maladaptive depressogenic cognitive styles than individuals without PTSD. The three groups were comparable in terms of pre-abuse mental health, childhood trauma history, and relationship violence variables and injuries. Maladaptive schemas did not contribute to the identification of comorbidity caseness, whereas PTSD severity and prior trauma did. Psychological aggression by an abuser and PTSD severity accounted for 52% of the variance in depressive symptoms.Limitations-Cross-sectional design and lack of trauma-specific cognitive measures.Conclusions-The findings confirm that comorbid PTSD and MDD is common among IPV victims. The mechanisms that contribute to comorbid depression, however, are unclear, and prospective studies are necessary to delineate the roles that psychological abuse, PTSD severity and prior trauma experiences may have in the development of depression following IPV.