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

Published online by Cambridge University Press:  07 November 2014

Patricia A. Resick ,
Pallavi Nishith  and
Michael G. Griffin
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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.

Type
Original Research
Information
CNS Spectrums , Volume 8 , Issue 5: Psychosocial Treatment of Anxiety Disorders , May 2003 , pp. 340 - 355
Copyright
Copyright © Cambridge University Press 2003

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References

REFERENCES

1.Kessler, R, Sonnega, A, Bromet, E, Hughes, M, Nelson, C. Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995;52:1048–1060.CrossRefGoogle ScholarPubMed
2.Resnick, HS, Kilpatrick, DG, Dansky, BS, Saunders, BE, Best, CL. Prevalence of civilian trauma and posttraumatic stress disorder in a representative national sample of women. J Consult Clin Psychol. 1993;61:984–991.CrossRefGoogle Scholar
3.Briere, J, Runtz, M. Symptomatology associated with childhood sexual victimization in a nonclinical adult sample. Child Abuse Negl. 1988;12:51–59.CrossRefGoogle Scholar
4.Gershenson, HP, Musick, JS, Ruch-Ross, HS, Magee, V, Rubino, KK, Rosenberg, D. The prevalence of coercive sexual experience among teenage mothers. J Interpers Violence. 1989;4:204–219.CrossRefGoogle Scholar
5.Jackson, JL, Calhoun, KS, Amick, AE, Madderer, HM, Habif, VL. Young adult women who report childhood intrafamilial sexual abuse: subsequent adjustment. Arch Sex Behav. 1990;19:211–221.CrossRefGoogle ScholarPubMed
6.Kendall-Tackett, K, Simon, A. Molestation and the onset of puberty: data from 365 adults molested as children. Child Abuse Negl.> 1988;12:73–81.CrossRefGoogle ScholarPubMed
7.Nishith, P, Mechanic, MB, Resick, PA. Prior interpersonal trauma: The contribution to current PTSD symptoms in female rape victims. J Abnorm Psychol. 2000;109:20–25.CrossRefGoogle ScholarPubMed
8.Wyatt, GE, Newcomb, M. Internal and external mediators of women's sexual abuse in childhood J Consult Clin Psychol. 1990;58:758–767.CrossRefGoogle ScholarPubMed
9.Koss, MP, Dinero, TE. Discriminant analysis of risk factors for sexual victimization among a national sample of college women. J Consult Clin Psychol. 1989;57:242–250.CrossRefGoogle ScholarPubMed
10.Norris, F, Johnson, K. The effects of “self-help” precautionary measures on criminal victimization and fear. J Urban Affairs. 1988;10:161–181.CrossRefGoogle Scholar
11.Norris, F, Kaniasty, K. Psychological distress following criminal victimization in the general population: cross-sectional, longitudinal, and prospective analyses. J Consult Clin Psychol. 1994;62:111–123.CrossRefGoogle ScholarPubMed
12.Herman, JL, Perry, C, van der Kolk, BA. Childhood trauma in borderline personality disorder. Am J Psychiatry. 1989;146:490–495.Google ScholarPubMed
13.Ogata, SN, Silk, KR, Goodrich, S, Lohr, NE, Westen, D, Hill, EM. Childhood sexual and physical abuse in adult patients with borderline personality disorder. Am J Psychiatry. 1990;147:1008–1013.Google ScholarPubMed
14.Saxe, GN, Chinman, G, Berkowitz, R, et al.Somatization in patients with dissociative disorders. Am J Psychiatry. 1994;151:1329–1335.Google ScholarPubMed
15.Ross, CA, Miller, SD, Reagor, P, Bjornson, L, Fraser, GA, Anderson, G. Multicenter structured interview data on 102 cases of multiple personality disorder from four centers. Am J Psychiatry. 1990;147:596–601.Google Scholar
16.Saxe, G, van der Kolk, BA, Hall, K, et al.Dissociative disorders in psychiatric inpatients. Am J Psychiatry. 1993;150:1037–1042.Google ScholarPubMed
17.van der Kolk, BA, Perry, C, Herman, Jl. Childhood origins of self-destructive behavior. Am J Psychiatry. 1991;148:1665–1671.Google ScholarPubMed
18.Herzog, DB, Staley, JE, Carmody, S, Robbins, WM, van der Kolk, BA. Childhood sexual abuse in anorexia nervosa and bulimia nervosa: a pilot study. J Am Acad Child Adol Psychiatry. 1993;32:962–966.CrossRefGoogle ScholarPubMed
19.Abueg, FR, Fairbank, JA. Behavioral treatment of posttraumatic stress disorder and co-occurring substance abuse. In: Saigh, PA, ed. Posttraumatic Stress Disorder: A Behavioral Approach to Assessment and Treatment Boston, Mass: Allyn & Bacon; 1992:111–146.Google Scholar
20.Donaldson, M, Gardner, J. Traumatic stress among women after childhood incest. In: Figley, C, ed. Trauma and Its Wake. New York, NY: Brunner/Mazel; 1985.Google Scholar
21.Lindberg, FH, Distad, LJ. Posttraumatic stress disorders in women who experienced childhood incest. Child Abuse Negl. 1985;9:329–334.CrossRefGoogle ScholarPubMed
22.Rodriguez, N, Ryan, SW, Kemp, HV, Foy, D. Posttraumatic stress disorder in adult female survivors of childhood sexual abuse: A comparison study. J Consult Clin Psychol. 1997;65:53–59.CrossRefGoogle ScholarPubMed
23.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association Press; 1994.Google Scholar
24.Herman, JL. Complex PTSD: a syndrome in survivors of prolonged and repeated trauma. J Traum Stress. 1992;5:377–391.CrossRefGoogle Scholar
25.Foa, EB, Rothbaum, BO, Riggs, DS, Murdock, TB. Treatment of posttraumatic stress disorder in rape victims: a comparison between cognitive-behavioral procedures. J Consult Clin Psychol. 1991;59:715–723.CrossRefGoogle ScholarPubMed
26.Foa, EB, Dancu, CV, Hembree, EA, Jaycox, LH, Meadows, EA, Street, GP. A comparison of exposure therapy, stress inoculation training, and their combination for reducing posttraumatic stress disorder in female assault victims. J Consult Clin Psychol. 1999;67:194–200.CrossRefGoogle ScholarPubMed
27.Resick, PASchnicke, MK. Cognitive processing therapy for sexual assault victims. J Consult Clin Psychol. 1992;60:748–756.CrossRefGoogle ScholarPubMed
28.Resick, PA, Schnicke, MK. Cognitive processing therapy for rape victims: a treatment manual. Newbury Park, Calif: Sage Publications; 1993.Google Scholar
29.Resick, PA, Nishith, P, Weaver, TL, Astin, MC, Feuer, CA. A comparison of cognitive processing therapy, prolonged exposure, and a waiting condition for the treatment of PTSD in female rape victims. J Consult Clin Psychol. 2002;70:867–879.CrossRefGoogle Scholar
30.Frank, E, Anderson, BP. Psychiatric disorders in rape victims: past history and current symptomatology. Compr Psychiatry. 1987;28:77–82.CrossRefGoogle ScholarPubMed
31.Frank, E, Turner, SM, Stewart, BD, Jacob, J, West, D. Past psychiatric symptoms and the response to sexual assault. Compr Psychiatry. 1981;22:479–487.CrossRefGoogle ScholarPubMed
32.Kramer, TL, Greene, BL. Posttraumatic stress disorder as an early response to sexual assault. J Interpers Viol. 1991;6:160–173.CrossRefGoogle Scholar
33.Roth, S, Wayland, K, Woolsey, M. Victimization history and victim-assailant relationship as factors in recovery from sexual assault. J Traum Stress. 1990;3:169–180.Google Scholar
34.Cloitre, M, Koenen, KC, Cohen, LR, Han, H. J Consult Clin Psychol. 2002;70:1067–1074.CrossRefGoogle Scholar
35.Blake, DD, Weathers, FW, Nagy, LM, et al.The development of a clinicianadministered PTSD scale. J Traum Stress. 1995;8:75–90.Google ScholarPubMed
36.Blake, DD, Weathers, FW, Nagy, LM, et al.A clinician rating scale for assessing current and lifetime PTSD: the CAPS-1. Behav Therapist. 1990;13:187–188.Google Scholar
37.Beck, AT, Ward, CH, Mendelsohn, M, Mock, J, Erbaugh, J. An inventory for measuring depression. Arch Gen Psychiatry, 1961;4:561–571.CrossRefGoogle ScholarPubMed
38.Beck, AT, Steer, RA, Garbin, MG. Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clin Psychol Rev. 1988;8:77–100.CrossRefGoogle Scholar
39.Briere, J. The Trauma Symptom Inventory (TSI): Professional Manual. Odessa, FL: Psychological Assessment Resources; 1995.Google Scholar
40.Resick, PA, Jordan, CG, Girelli, SA, Hutter, CK, Marhoefer-Dvorak, S. A comparative outcome study of group behavior therapy for sexual assault victims, Behav Ther. 1988;19:385–401.CrossRefGoogle Scholar
41.Rowan, AB, Foy, DW, Rodriguez, N, Ryan, S. Posttraumatic stress disorder in a clinical sample of adults sexually abused as children. Child Abuse Negl. 1994;18:51–61.CrossRefGoogle Scholar
42.Zaidi, LY, Knutson, JF, Mehm, JG. Transgenerational patterns of abusive parenting: Analog and clinical tests. Aggress Behav. 1989;15:137–152.3.0.CO;2-O>CrossRefGoogle Scholar
43.Foa, EB, Rothbaum, BO. Treating the Trauma of Rape. New York, NY: Guilford Press; 1997.Google Scholar
44.Erdfelder, E, Faul, F, Buchner, A. GPOWER: a general power analysis program. Behav Res Methods Instrum Comput. 1996;28:1–11.CrossRefGoogle Scholar
45.Pelcovitz, D, van der Kolk, B, Roth, S, et al.Development of a criteria set and a structured interview for disorders of extreme stress (SIDES). J Traum Stress. 1997;10:3–16.CrossRefGoogle Scholar
46.Briere, J. Complex psychological trauma: clinical implications of an evolving paradigm. Presidential Address at the 18th Annual Meeting of the International Society for Traumatic Stress Studies; November 7-10, 2002; Baltimore, MD.Google Scholar