The PI proposes to study the role of cognition, particularly the victim's perception of the meaning of the event, as it relates to an information processing theory of crime-related PTSD. The overall goals of the project are theoretical as well as methodological. The role of cognition and attributions will be examined in a prospective study with recent rape victims to investigate cognition and recovery (Study 1); and within the context of treatment to determine if direct intervention with attributions and beliefs plus exposure is more effective than cognitive therapy only, exposure only, or a minimal attention control (study 2). In Study 1, social support and coping strategies will also be studied as possible mediating factors which may play a role in facilitating or hindering processing the event. Study 1 will compare 200 rape victims at one month and three months postcrime with 100 nonvictims seen at the same intervals. The second study will include 120 rape victims three months or more following their assault, meeting the criteria for PTSD, who will be randomly assigned to one of four conditions: cognitive processing therapy, direct therapeutic exposure, cognitive therapy, or a minimal attention condition. The PI will also attempt to develop multiaxial methods for assessing PTSD in rape victims. A range of techniques will be used to assess concurrent psychophysiological reactions, nonverbal behavior, cognition and emotions, as well as the self-reported symptoms more commonly studied. Furthermore, this study will examine the relationship between these measures in both victim and nonvictim groups. As with the theoretical issues, the methodological issues will be explored as part of the prospective assessment study and the treatment study. During assessments, participants will complete symptom inventories and a diagnostic interview. They will then complete attribution and cognitive scales. The final portion will be a videotaped, physiological assessment. After a resting baseline, subjects will be interviewed about neutral topics, have another baseline phase, then describe the rape, followed by a final baseline.
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