Over the past 7 years we have developed and evaluated brief treatments for post-traumatic stress disorder (PTSD) following sexual assault. The proposed study is intended to replicate and extend our treatment studies, and has both practical and theoretical aims. First, Stress Inoculation Training plus Prolonged Exposure (SIT/PE), a successful treatment that we have developed over the last 3 years, will be extended to a community rape crisis center (Women Organized Against Rape [WOAR]). The treatment efficacy at WOAR will be compared with that at our research clinic (Medical College of Pennsylvania), so that its transportability can be ascertained. Second, a new treatment program which is a theoretically and empirically derived refinement of SIT/PE, Cognitive Therapy plus Prolonged Exposure (CT/PE), will also be evaluated in both the research and community settings. Third, the efficacy of 3 additional sessions for partial responders will be examined. The proposed research will also address theoretical issues regarding cognitive processes underlying PTSD and its amelioration by cognitive-behavioral treatment. Specifically, we will examine the relationship of perceptions of the dangerousness of the world, and of one's ability to cope with stress to PTSD and other post- trauma psychopathology. We will also investigate whether the victim's perceptions of aversive events as unpredictable and uncontrollable are associated with PTSD and whether changes in such perceptions via treatment produce improvement. A total of 180 rape victims with PTSD will be randomly assigned to SIT/PE, CT/PE, or a waitlist, half at MCP, and half at WOAR. Assessments will include structured interviews and questionnaires, and will be conducted before treatment, after treatment, and at 3, 6, and 12 months follow-up. Dependent measures will be PTSD symptoms severity and diagnosis, general psychopathology, depression, social function, coping style, cognitive schemas, treatment expectancy, and treatment compliance.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
2R01MH042178-09
Application #
2245382
Study Section
Violence and Traumatic Stress Review Committee (VTS)
Project Start
1994-09-01
Project End
1999-08-31
Budget Start
1994-09-01
Budget End
1995-08-31
Support Year
9
Fiscal Year
1994
Total Cost
Indirect Cost
Name
Allegheny University of Health Sciences
Department
Psychiatry
Type
Schools of Medicine
DUNS #
City
Philadelphia
State
PA
Country
United States
Zip Code
19129
Chang, Cindy; Kaczkurkin, Antonia N; McLean, Carmen P et al. (2018) Emotion regulation is associated with PTSD and depression among female adolescent survivors of childhood sexual abuse. Psychol Trauma 10:319-326
Jayawickreme, Nuwan; Cahill, Shawn P; Riggs, David S et al. (2014) Primum non nocere (first do no harm): symptom worsening and improvement in female assault victims after prolonged exposure for PTSD. Depress Anxiety 31:412-9
Zoellner, Lori A; Feeny, Norah C; Eftekhari, Afsoon et al. (2011) Changes in negative beliefs following three brief programs for facilitating recovery after assault. Depress Anxiety 28:532-40
Moser, Jason S; Cahill, Shawn P; Foa, Edna B (2010) Evidence for poorer outcome in patients with severe negative trauma-related cognitions receiving prolonged exposure plus cognitive restructuring: implications for treatment matching in posttraumatic stress disorder. J Nerv Ment Dis 198:72-5
Rauch, Sheila A M; Grunfeld, Tania E E; Yadin, Elna et al. (2009) Changes in reported physical health symptoms and social function with prolonged exposure therapy for chronic posttraumatic stress disorder. Depress Anxiety 26:732-8
Tolin, David F; Foa, Edna B (2006) Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research. Psychol Bull 132:959-92
Foa, Edna B; Hembree, Elizabeth A; Cahill, Shawn P et al. (2005) Randomized trial of prolonged exposure for posttraumatic stress disorder with and without cognitive restructuring: outcome at academic and community clinics. J Consult Clin Psychol 73:953-64
Hembree, Elizabeth A; Street, Gordon P; Riggs, David S et al. (2004) Do assault-related variables predict response to cognitive behavioral treatment for PTSD? J Consult Clin Psychol 72:531-4
Feeny, Norah C; Zoellner, Lori A; Foa, Edna B (2002) Treatment outcome for chronic PTSD among female assault victims with borderline personality characteristics: a preliminary examination. J Pers Disord 16:30-40
Gilboa-Schechtman, E; Foa, E B (2001) Patterns of recovery from trauma: the use of intraindividual analysis. J Abnorm Psychol 110:392-400

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