Psychological Treatment of Chronic Posttraumatic Stress Disorder in Victims of Sexual Aggression

Abstract

The aim of this research was to test the comparative effectiveness of two therapeutic modalities in the treatment of chronic posttraumatic stress disorder in victims of sexual aggression: (a) self-exposure and cognitive restructuring and (b) progressive relaxation training. The sample consisted of 20 patients (victims of rape in adulthood or adult victims of childhood sexual abuse) selected according to DSM-III-R criteria. A multigroup experimental design with repeated measures (pretreatment, posttreatment, and 1-, 3-, 6-, and 12-month follow-up) was used. Most treated patients improved, but the success rate was higher in all measures in the exposure and cognitive restructuring group immediately on posttreatment and at follow-up. Implications of this study for clinical practice and future research in this field are commented on.

Treating Acute Stress Disorder and Posttraumatic Stress Disorder with Cognitive Behavioral Therapy or Structured Writing Therapy: A Randomized Controlled Trial

“…The efficacy of cognitive behavioral therapy (CBT) in treating ASD [4, 5] and PTSD in its acute [6, 7] and chronic [8,9,10] stages is well established. CBT emerged as a psychological treatment of choice for PTSD in authoritative meta-analyses [11,12,13], along with eye movement desensitization and reprocessing.…”

Transcranial magnetic stimulation and transcranial direct current stimulation appear to be safe neuromodulatory techniques useful in the treatment of anxiety disorders and other neuropsychiatric disorders

“…Furthermore, the small number of subjects in these analyses limits any generalization of the findings, which increases the need for further studies with larger samples and improved stimulation parameters 50 ; moreover, the mechanism of action of rTMS in anxiety disorders needs to be further clarified, by combining TMS with neuroimaging 51 . In addition to treatment with rTMS, PTSD is also treated through exposure to objects and events that induce anxiety and memories of aversive episodes 52 , but in a controlled environment so that patients know that they are not in danger. Finally, the frequent coexistence of anxiety and mood disorders justifies the concomitant study, for example, of panic disorder (PD) and major depressive disorders with rTMS.…”

Empirically supported psychological treatments for adult acute stress disorder and posttraumatic stress disorder: a review

“…[17,18,29,32,39,41,44,47,52,55,[59][60][61][62][63][64][65][66][67][68][69][70][71][72][73] The duration of cognitive restructuring with exposure in these trials ranged from 4 to 20 sessions, with the exception of an internet-based intervention that involved 1 face-to-face session with a therapist followed by e-mail and telephone contact.…”

“…In studies that had diagnosis as an outcome measure, between 47 and 94% of exposure plus cognitive restructuring patients no longer met diagnostic criteria for PTSD at the end of treatment in completer analyses. [17,18,32,52,59,[61][62][63]65,67,69,70] The issue of whether trauma-focused CBT involving a combination of cognitive restructuring of maladaptive trauma-related beliefs and exposure is more effective than exposure alone or cognitive restructuring alone has been investigated in several studies. The research team that found the strongest evidence of this matched time spent on components of trauma-focused CBT for mixed trauma patients across conditions, using supportive counseling in those conditions without the full range of techniques.…”

“…[15] Both of these studies by Foa and colleagues included diagnosis as an outcome measure, and found 50% [14] and 58% [15] of stress inoculation completers no longer met diagnostic criteria for PTSD at the end of treatment. Stress management involving some form of relaxation training is significantly less efficacious than trauma-focused CBTentailing exposure, [39,45] cognitive restructuring of maladaptive trauma-related beliefs, [39] or a combination of both [39,59] in decreasing PTSD symptoms. Survivors of assault or abuse and mixed trauma patients were recruited in these studies.…”