This proposal is for a competing renewal of a treatment outcome study on Posttraumatic Stress Disorder (PTSD). The current study is a clinical trial comparing cognitive processing therapy (CPT) with prolonged exposure and a minimal attention waiting-list condition for the treatment of PTSD among victims of rape. The goal of the proposed study is to examine the individual procedural elements of CPT by using a dismantling design. In addition, a secondary goal is to determine if these elements have differential efficacy in the treatment of primary and secondary emotions that are associated with PTSD. Third, the study will examine the generalization of CPT from the treatment of female rape victims to female victims of physical assault. The study will also examine the efficacy of the three methods on self-reported health status. The study will include 120 female participants who are victims of rape or physical assault and are suffering from PTSD. Participants will be randomly assigned to one of the three treatment conditions: cognitive processing therapy, cognitive therapy, or written exposure therapy. Participants in the study will be administered a battery of interviews and self-report measures of symptoms and cognitions. Guilt and shame will be studied as secondary emotions along with a range of beliefs about oneself and the world. In addition, two different types of physiological assessment (verbal processing and startle) will be used to determine if the individual procedural elements of CPT have a differential effect on verbally or situationally accessed memory. Heart rate, skin conductance response, and EMG will be assessed. Participants will be assessed at pretreatment, posttreatment, and at 6-months follow-up. In addition, the participants will be further assessed on a self-report measure of PTSD every week during treatment. The proposed study should make an important contribution to knowledge about treatment and recovery from PTSD. At a theoretical level, the proposed study will also provide an opportunity to investigate theoretical mechanisms hypothesized to be involved in recovery from PTSD.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH051509-10
Application #
6739647
Study Section
Special Emphasis Panel (ZMH1-ITV-D (01))
Program Officer
Tuma, Farris K
Project Start
1994-05-01
Project End
2006-04-30
Budget Start
2004-05-01
Budget End
2006-04-30
Support Year
10
Fiscal Year
2004
Total Cost
$366,935
Indirect Cost
Name
University of Missouri-St. Louis
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
804883825
City
Saint Louis
State
MO
Country
United States
Zip Code
63121
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Larsen, Sadie E; Wiltsey Stirman, Shannon; Smith, Brian N et al. (2016) Symptom exacerbations in trauma-focused treatments: Associations with treatment outcome and non-completion. Behav Res Ther 77:68-77
Iverson, Katherine M; King, Matthew W; Cunningham, Katherine C et al. (2015) Rape survivors' trauma-related beliefs before and after Cognitive processing therapy: associations with PTSD and depression symptoms. Behav Res Ther 66:49-55
Galovski, Tara E; Elwood, Lisa S; Blain, Leah M et al. (2014) Changes in Anger in Relationship to Responsivity to PTSD Treatment. Psychol Trauma 6:56-64
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

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