How Well Does Cognitive-Behavioral Therapy Treat Symptoms of Complex PTSD? An Examination of Child Sexual Abuse Survivors Within A Clinical Trial

Abstract

Are brief cognitive-behavioral treatments for posttraumatic stress disorder (PTSD) also effective for the wider range of symptoms conceptualized as complex PTSD? Female rape victims, most of whom had extensive histories of trauma, were randomly assigned to cognitive-processing therapy, prolonged exposure, or a delayed-treatment waiting-list condition. After determining that both types of treatment were equally effective for treating complex PTSD symptoms, we divided the sample of 121 participants into two groups depending upon whether they had a history of child sexual abuse. Both groups improved significantly over the course of treatment with regard to PTSD, depression, and the symptoms of complex PTSD as measured by the Trauma Symptom Inventory. Improvements were maintained for at least 9 months. Although there were group main effects on the Self and Trauma factors, there were no differences between the two groups at posttreatment once pretreatment scores were covaried. These findings indicate that cognitive-behavioral therapies are effective for patients with complex trauma histories and symptoms patterns.

Developing an Emotion- and Memory-Processing Group Intervention for PTSD with complex features: a group case series with survivors of repeated interpersonal trauma

“…Seven of the 15 participants had experienced too many to count past traumatic experiences due to prolonged abuse in childhood or an adult relationship. Baseline severity on the CAPS was comparable with levels reported in a high dissociation sample of victims of childhood sexual and/or physical abuse (Cloitre et al, 2012), victims of childhood sexual abuse (Chard, 2005), and rape victims with a childhood sexual abuse history (Resick et al, 2003). …”

“…A number of authors propose that trauma-focused treatments can be offered to those who have experienced repeated interpersonal trauma without any major modifications (e.g. Cook, Schnurr, & Foa, 2004; Resick, Nishith, & Griffin, 2003; Van Minnen et al, 2012). Others propose that outcomes for complex presentations can be improved using a phase-based or sequenced approach involving three phases, each with a distinct function (e.g.…”

Internalizing and Externalizing Subtypes in Female Sexual Assault Survivors: Implications for the Understanding of Complex PTSD

“…We had hypothesized, on the basis of Herman's (1992) conceptualization and evidence for the role of early developmental trauma and repeated traumatization in the etiology of the complex PTSD (Ford, 1999;McLean & Gallop, 2003;Resick et al, 2003;Roth et al, 1997), that internalizers and externalizers would report more extensive trauma histories and be more likely to endorse histories of childhood sexual abuse than those in the simple PTSD group. This was a severely and repeatedly traumatized sample of rape survivors who reported high rates of childhood physical and sexual abuse as well as adult criminal victimization.…”

“…Finally, on the basis of Herman's (1992) conceptualization of complex PTSD, and evidence for the role of early developmental trauma and repeated traumatization in the etiology of the disorder (Ford, 1999;McLean & Gallop, 2003;Resick, Nishith, & Griffin, 2003;Roth, Newman, Pelcovitz, van der Kolk, & Mandel, 1997), we hypothesized that internalizers and externalizers would report more extensive trauma histories and be more likely to endorse histories of childhood sexual abuse than those in the simple/low pathology PTSD group.…”

Phenomenology and psychological assessment of complex posttraumatic states

“…The TSI has three validity scales (Response Level, Atypical Response, and Inconsistent Response) and 10 clinical scales (Anxious Arousal, Depression, Anger/Irritability, Intrusive Experiences, Defensive Avoidance, Dissociation, Sexual Concerns, Dysfunctional Sexual Behavior, Impaired Self-Reference, and Tension Reduction Behavior), the latter of which appear sensitive to the effects of a variety of different traumatic events (e.g., Green et al, 2000;Runtz & Roche, 1999). The variety of symptoms assessed by the TSI has resulted in the use of this measure as a broad spectrum measure of complex posttraumatic outcomes (e.g., Resick, Nishith, & Griffin, 2003).…”