Few studies have examined the impact of trauma research participation upon trauma survivors. Empirical data regarding reactions to research participation would be very useful to address the question of whether it is harmful for trauma survivors to participate in trauma studies. We examined participant reactions to different trauma assessment procedures in domestic violence (N = 260), rape (N = 108), and physical assault (N = 62) samples. Results indicated that participation was very well tolerated by the vast majority of the trauma survivors. Participants generally found that the assessment experience was not distressing and was, in fact, viewed as an interesting and valuable experience. The findings suggest that trauma survivors are not too fragile to participate in trauma research even in the acute aftermath of a traumatic experience.

Curve estimation techniques were used to identify the pattern of therapeutic change in female rape victims with posttraumatic stress disorder (PTSD). Within-session data on the Posttraumatic Stress Disorder Symptom Scale were obtained, in alternate therapy sessions, on 171 women. The final sample of treatment completers included 54 prolonged exposure (PE) and 54 cognitive-processing therapy (CPT) completers. For both PE and CPT, a quadratic function provided the best fit for the total PTSD, reexperiencing, and arousal scores. However, a difference in the line of best fit was observed for the avoidance symptoms. Although a quadratic function still provided a better fit for the PE avoidance, a linear function was more parsimonious in explaining the CPT avoidance variance. Implications of the findings are discussed.The purpose of controlled therapy outcome research is to identify specific cause-and-effect relationships that increase knowledge of mechanisms of change for affecting psychopathology and, consequently, allow for the development of increasingly effective psychotherapies (Borkovec & Miranda, 1999). Although comparisons of treatment with no-treatment conditions allow one to rule out the role of history, maturation, repeated testing, and statistical regression as explanatory factors for differences in treatment outcome, comparisons of treatment with placebo or a minimal-attention group allow one to conclude that something specific to the treatment condition, above and beyond the general therapeutic relationship, is responsible for therapeutic change (Borkovec & Castonguay, 1998).Once the efficacy of a new therapy is established in the initial stages through controlled trials, comparative designs are generally used to determine whether the therapy is superior to another treatment or matches the outcome of an already established treatment with adequate statistical power. Although comparative designs are useful for demonstrating empirical support for a new therapy, these designs are confounded by the fact that the two compared therapies are inherently different in a large number of ways. However, the results of comparative studies are useful in that they can help both of the treatments in question evolve and change on the basis of new clinical and empirical knowledge that is obtained over the course of the clinical trial (Devilly & Foa, 2001;Tarrier, 2001).Treatment-outcome research with female rape victims has largely involved the use of controlled and comparative trials. Two of the more researched treatments used with this population are prolonged exposure therapy (PE;Foa et al., 1999; Murdock, 1991) and cognitive-processing therapy (CPT; Resick & Schnicke, 1992. Clinical trials conducted with these therapies established the initial efficacy for both these treatments (Foa et al., 1991Resick & Schnicke, 1992. More recently, Resick, Nishith, Weaver, Astin, and Feuer (2002) conducted a clinical trial comparing PE and CPT with a minimal-attention (MA) control group. Although both therapies proved to b...

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.

In the immediate aftermath of a traumatic event, many individuals experience physiological reactivity in response to reminders of the traumatic event that typically lessens over time. However, an overreliance on avoidant coping strategies may interfere with the natural recovery process, particularly for those who are highly reactive to trauma reminders. In the current investigation, we examined avoidant coping as a moderator of the association between heart rate reactivity to a trauma monologue measured shortly after a traumatic event and severity of posttraumatic stress disorder (PTSD) symptoms measured several months later. Fifty-five female survivors of assault completed PTSD diagnostic interviews and a self-report coping measure and participated in a trauma monologue procedure that included continuous heart rate measurement. These procedures were completed within 1 month of the assault and again 3 months postassault. After we controlled for the effect of initial symptom levels, the interaction of heart rate reactivity to the trauma monologue and avoidant coping measured at Time 1 was associated with PTSD symptom severity at Time 2. Individuals who are relatively highly reliant on avoidant coping strategies and relatively highly reactive to trauma reminders may be at greatest risk of maintaining or potentially increasing their PTSD symptoms within the first few months following the trauma. These findings may help inform early intervention efforts for survivors of traumatic events.

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