Cognitive Changes During Prolonged Exposure Versus Prolonged Exposure Plus Cognitive Restructuring in Female Assault Survivors With Posttraumatic Stress Disorder.

Abstract

The authors report on changes in cognitions related to posttraumatic stress disorder (PTSD) among 54 female survivors of sexual and nonsexual assault with chronic PTSD who completed either prolonged exposure alone or in combination with cognitive restructuring. Treatment included 9-12 weekly sessions, and assessment was conducted at pretreatment, posttreatment, and a modal 12-month follow-up. As hypothesized, treatment that included prolonged exposure resulted in clinically significant, reliable, and lasting reductions in negative cognitions about self, world, and self-blame as measured by the Posttraumatic Cognitions Inventory. The hypothesis that the addition of cognitive restructuring would augment cognitive changes was not supported. Reductions in these negative cognitions were significantly related to reductions in PTSD symptoms. The addition of cognitive restructuring did not significantly augment the cognitive changes. Theoretical implications of the results are discussed.

Posttraumatic stress disorder symptoms in trauma-exposed college students: The role of trauma-related cognitions, gender, and negative affect

“…Interestingly, the present results are consistent with those of Foa and Rauch (2004) that were obtained in a patient population who found a stronger relationship between PTSD symptom severity and negative cognitions about the self than negative cognitions about the world. In addition, gathering data from a large sample of individuals who report a range of posttraumatic stress symptoms is important because PTSD can best be viewed as a dimensional construct rather than a categorical construct (Ruscio et al, 2002).…”

“…Together, these data provide support for the unique importance of negative cognitions about the self in relation to PTSD symptom severity. These data are consistent with the findings of Foa and Rauch (2004), who reported that reductions in negative cognitions about the self were related to decreases in PTSD symptoms following prolonged exposure therapy whereas reduction in negative cognitions about the world were related to reduction of PTSD through their relations to cognitions about self. Overall, cognitions about the self appear to be more related to PTSD symptom severity than other types of traumarelated cognitions.…”

“…Through the systematic repeated exposure to the traumatic memory and trauma-related stimuli, clients undergoing PE were presented with information that disconfirmed their negative posttraumatic beliefs (Foa & Rothbaum, 1998). Consistent with their hypothesis that changes in negative posttraumatic cognitions would be associated with reduction of PTSD symptoms, Foa and Rauch (2004) found that reductions in both negative cognitions about the self and world were associated with reductions in PTSD symptoms. Association between changes in cognitions about the world and reduction in PTSD symptoms, however, were mediated by cognitive changes about the self.…”

“…More recently, Foa and Rauch (2004) utilized the PTCI to measure the relationship between changes in trauma-related cognitions and changes in PTSD symptoms following prolonged exposure (PE) therapy in a small sample of female assault survivors with PTSD. Through the systematic repeated exposure to the traumatic memory and trauma-related stimuli, clients undergoing PE were presented with information that disconfirmed their negative posttraumatic beliefs (Foa & Rothbaum, 1998).…”

“…The validation study of the PTCI included a large sample of treatment-seeking individuals with PTSD, community volunteers, and college students. In support of the emotional processing theory of PTSD, found that individuals who met criteria for current PTSD had more negative beliefs about the world and themselves (including self-blame) compared to traumatized individuals without PTSD and non-traumatized individuals.More recently, Foa and Rauch (2004) utilized the PTCI to measure the relationship between changes in trauma-related cognitions and changes in PTSD symptoms following prolonged exposure (PE) therapy in a small sample of female assault survivors with PTSD. Through the systematic repeated exposure to the traumatic memory and trauma-related stimuli, clients undergoing PE were presented with information that disconfirmed their negative posttraumatic beliefs (Foa & Rothbaum, 1998).…”