Change in rape narratives during exposure therapy for posttraumatic stress disorder

Foa, Edna B.; Molnar, Chris; Cashman, Laurie

doi:10.1002/jts.2490080409

Cited by 404 publications

(329 citation statements)

References 31 publications

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“…Moreover, smaller HR increases during trauma recall were found to predict poorer recovery in PTSD symptoms six months later. These findings of lowered cardiovascular reactivity are reminiscent of the proposal that limited emotional arousal impedes the processing of traumatic memories (Foa, Molnar, & Cashman, 1995). …”

Section: Heart Rate As An Index Of Emotional Arousalmentioning

confidence: 58%

Cardiovascular and psychological responses to voluntary recall of trauma in posttraumatic stress disorder

Chou

Marca

Steptoe

et al. 2018

European Journal of Psychotraumatology

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Voluntary recall of trauma is a key element in exposure-based psychotherapies and can trigger spontaneous dissociative responses such as flashbacks, depersonalisation, and derealisation. In order to examine the associations between cardiovascular and psychological responses to voluntary recollection of trauma, individuals with PTSD recalled a traumatic memory. Heart rate and heart rate variability were recorded continuously and the episodes when different forms of dissociation were experienced during the recall were identified. A significant increase in parasympathetic activity was found during trauma recall, with greater parasympathetic dominance being indicative of greater state depersonalisation/derealisation. Whereas overall decreases in heart rate during trauma recall were associated with increased fear and perceived threat, flashbacks were accompanied by short-term increases in heart rate. These findings demonstrate different types of cardiovascular responses associated with different psychological experiences during trauma recall. Future research directions were discussed.

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Section: Heart Rate As An Index Of Emotional Arousalmentioning

confidence: 58%

Cardiovascular and psychological responses to voluntary recall of trauma in posttraumatic stress disorder

Chou

Marca

Steptoe

et al. 2018

European Journal of Psychotraumatology

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“…The Posttraumatic Stress Diagnostic Scale (PDS; Foa et al 234 ), a 49-item self-reported measure, aids in PTSD diagnosis and symptom severity, with items that parallel DSM-IV criteria 235,236 ) is designed as a screening instrument for use with health-care seeking populations It provides information on perceived symptoms of (a) depression, (b) anxiety, (c) somatic complaints, and (d) psychological distress…”

Section: Pdsmentioning

confidence: 99%

Does therapeutic writing help people with long-term conditions? Systematic review, realist synthesis and economic considerations

Nyssen

Taylor

Wong

et al. 2016

Health Technol Assess

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BackgroundWriting therapy to improve physical or mental health can take many forms. The most researched model of therapeutic writing (TW) is unfacilitated, individual expressive writing (written emotional disclosure). Facilitated writing activities are less widely researched.Data sourcesDatabases, including MEDLINE, EMBASE, PsycINFO, Linguistics and Language Behaviour Abstracts, Allied and Complementary Medicine Database and Cumulative Index to Nursing and Allied Health Literature, were searched from inception to March 2013 (updated January 2015).Review methodsFour TW practitioners provided expert advice. Study procedures were conducted by one reviewer and checked by a second. Randomised controlled trials (RCTs) and non-randomised comparative studies were included. Quality was appraised using the Cochrane risk-of-bias tool. Unfacilitated and facilitated TW studies were analysed separately underInternational Classification of Diseases, Tenth Revision chapter headings. Meta-analyses were performed where possible using RevMan version 5.2.6 (RevMan 2012, The Cochrane Collaboration, The Nordic Cochrane Centre, Copenhagen, Denmark). Costs were estimated from a UK NHS perspective and three cost–consequence case studies were prepared. Realist synthesis followed Realist and Meta-narrative Evidence Synthesis: Evolving Standards guidelines.ObjectivesTo review the clinical effectiveness and cost-effectiveness of TW for people with long-term conditions (LTCs) compared with no writing, or other controls, reporting any relevant clinical outcomes. To conduct a realist synthesis to understand how TW might work, and for whom.ResultsFrom 14,658 unique citations, 284 full-text papers were reviewed and 64 studies (59 RCTs) were included in the final effectiveness reviews. Five studies examined facilitated TW; these were extremely heterogeneous with unclear or high risk of bias but suggested that facilitated TW interventions may be beneficial in individual LTCs. Unfacilitated expressive writing was examined in 59 studies of variable or unreported quality. Overall, there was very little or no evidence of any benefit reported in the following conditions (number of studies): human immunodeficiency virus (six); breast cancer (eight); gynaecological and genitourinary cancers (five); mental health (five); asthma (four); psoriasis (three); and chronic pain (four). In inflammatory arthropathies (six) there was a reduction in disease severity [n = 191, standardised mean difference (SMD) –0.61, 95% confidence interval (CI) –0.96 to –0.26] in the short term on meta-analysis of four studies. For all other LTCs there were either no data, or sparse data with no or inconsistent, evidence of benefit. Meta-analyses conducted acrossallof the LTCs provided no evidence that unfacilitated emotional writing had any effect on depression at short- (n = 1563, SMD –0.06, 95% CI –0.29 to 0.17, substantial heterogeneity) or long-term (n = 778, SMD –0.04 95% CI –0.18 to 0.10, little heterogeneity) follow-up, or on anxiety, physiological or biomarker-based outcomes. One study reported costs, no studies reported cost-effectiveness and 12 studies reported resource use; and meta-analysis suggested reduced medication use but no impact on health centre visits. Estimated costs of intervention were low, but there was insufficient evidence to judge cost-effectiveness. Realist synthesis findings suggested that facilitated TW is a complex intervention and group interaction contributes to the perception of benefit. It was unclear from the available data who might benefit most from facilitated TW.LimitationDifficulties with developing realist synthesis programme theory meant that mechanisms operating during TW remain obscure.ConclusionsOverall, there is little evidence to support the therapeutic effectiveness or cost-effectiveness of unfacilitated expressive writing interventions in people with LTCs. Further research focused on facilitated TW in people with LTCs could be informative.Study registrationThis study is registered as PROSPERO CRD42012003343.FundingThe National Institute for Health Research Health Technology Assessment programme.

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“…These results suggest that the processes of organizing and articulating the traumatic memories are involved in post-trauma recovery. The hypothesis that narrative organization is related to recovery was also supported in a treatment study conducted by Foa et al (1995). In this study the content of the initial and last narrative recounted by sexual and non-sexual assault victims during exposure therapy was analysed using a coding system developed speci®cally for the study.…”

mentioning

confidence: 99%

Linguistic predictors of trauma pathology and physical health

Alvarez-Conrad

Zoellner

Foa

2001

Applied Cognitive Psychology

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101

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The present study examined how speci®c linguistic elements in trauma narratives were associated with post-treatment psychopathology and physical symptoms. We analysed the narratives of 28 female assault victims being treated for chronic PTSD. During exposure therapy, participants were asked to recount their assault`as if it was happening now'. These trauma narratives were videotaped, transcribed, and analysed using a linguistic coding program. In particular, narratives containing words about death and dying were associated with worse post-treatment functioning. This relationship could not be accounted for by assault-related characteristics. The focus on death and dying in the trauma narrative may re¯ect the concept of mental defeat, suggesting a possible target for intervention in cognitive-behavioural treatment of PTSD.

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Change in rape narratives during exposure therapy for posttraumatic stress disorder

Cited by 404 publications

References 31 publications

Cardiovascular and psychological responses to voluntary recall of trauma in posttraumatic stress disorder

Cardiovascular and psychological responses to voluntary recall of trauma in posttraumatic stress disorder

Does therapeutic writing help people with long-term conditions? Systematic review, realist synthesis and economic considerations

Linguistic predictors of trauma pathology and physical health

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