The purpose of this study was to compare cognitive-processing therapy (CPT) with prolonged exposure and a minimal attention condition (MA) for the treatment of posttraumatic stress disorder (PTSD) and depression. One hundred seventy-one female rape victims were randomized into 1 of the 3 conditions, and 121 completed treatment. Participants were assessed with the ClinicianAdministered PTSD Scale, the PTSD Symptom Scale, the Structured Clinical Interview for DSM-IV, the Beck Depression Inventory, and the Trauma-Related Guilt Inventory. Independent assessments were made at pretreatment, posttreatment, and 3 and 9 months posttreatment. Analyses indicated that both treatments were highly efficacious and superior to MA. The 2 therapies had similar results except that CPT produced better scores on 2 of 4 guilt subscales.Cognitive-processing therapy (CPT) was introduced as a possible treatment for posttraumatic stress disorder (PTSD) nearly a decade ago. CPT, specifically designed for the treatment of PTSD resulting from sexual assault, consists of two integrated components: cognitive therapy and exposure in the form of writing and reading about the traumatic event Resick & Schnicke, 1992. The therapy focuses initially on assimilated-distorted beliefs such as denial and self-blame. Then the focus shifts to overgeneralized beliefs about oneself and the world. Beliefs and assumptions held before the trauma are also considered. Clients are taught to challenge their beliefs and assumptions through Socratic questioning and the use of daily worksheets. Once dysfunctional beliefs are deconstructed, more balanced self-statements are generated and practiced. The exposure component consists of having clients write detailed accounts of the most traumatic incident(s) that they read to themselves and to the therapists. Clients are encouraged to experience their emotions while writing and reading, and the accounts are then used to determine "stuck points": areas of conflicting beliefs, leaps of logic, or blind assumptions.In addition to a series of case study reports that indicated the therapy to be promising (Calhoun & Resick, 1993;Resick & Markway, 1991), Resick and Schnicke (1992) reported on CPT presented in a group-therapy format as compared with a naturally occurring wait-list condition. This 12-session therapy appeared to be effective for both PTSD and depressive symptoms in a first report in which 19 women treated with CPT were compared with 20 wait-list women. At 3-and 6-month follow-ups, none of the treated women met the NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript criteria for PTSD (Resick & Schnicke, 1992). Although there was no specific bias in assignment to condition, there was not, unfortunately, random assignment to groups, nor was there independent assessment. Subsequently, the treatment manual was published with data reported on 36 women who were treated in a group format and 9 who completed individual treatment. The therapy package continued to be quite promising.Clearly, the ...
Battered women are exposed to multiple forms of intimate partner abuse. This article explores the independent contributions of physical violence, sexual coercion, psychological abuse, and stalking on symptoms of posttraumatic stress disorder (PTSD) and depression among a sample of 413 severely battered, help-seeking women. The authors test the unique effects of psychological abuse and stalking on mental health outcomes, after controlling for physical violence, injuries, and sexual coercion. Mean scores for the sample fall into the moderate to severe range for PTSD and within the moderate category for depression scores. Hierarchical regressions test the unique effects of stalking and psychological abuse, after controlling for physical violence, injuries, and sexual coercion. Psychological abuse and stalking contribute uniquely to the prediction of PTSD and depression symptoms, even after controlling for the effects of physical violence, injuries, and sexual coercion. Results highlight the importance of examining multiple dimensions of intimate partner abuse.
The aims of this study were to provide descriptive data on stalking in a sample of acutely battered women and to assess the interrelationship between constructs of emotional abuse, physical violence, and stalking in battered women. We recruited a sample of 114 battered women from shelters, agencies, and from the community at large. Results support the growing consensus that violent and harassing stalking behaviors occur with alarming frequency among physically battered women, both while they are in the relationship and after they leave their abusive partners. Emotional and psychological abuse emerged as strong predictors of within- and postrelationship stalking, and contributed a unique variance to women’s fears of future serious harm or death, even after the effects of physical violence were controlled. The length of time a woman was out of the violent relationship was the strongest predictor of postseparation stalking, with increased stalking found with greater time out of the relationship. Results suggest the need to further study the heterogeneity of stalking and to clarify its relationship to constructs of emotional and physical abuse in diverse samples that include stalked but nonbattered women, as women exposed to emotional abuse, and dating violence.
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