This application seeks to increase the effectiveness of an existing treatment strategy, cognitive processing therapy (CPT), for the remediation of Posttraumatic Stress Disorder among crime victims by varying the duration and content of the intervention in accordance with participants'needs. A secondary goal is to identify predictors of duration of treatment necessary to achieve good end state functioning, including individual and trauma variables, cognitive and emotional variables, and Axis II pathology. Finally, by including a sample of male participants, the generalizability of CPT will be tested. It is anticipated that these modifications will speed the dissemination of CPT to community practice thus benefiting more trauma victims. Fifty subjects will be randomly assigned to either the modified CPT condition or to a symptom-monitoring, minimal attention condition designed to control for the effects of the daily monitoring and the passage of time. Utilizing a semicrossover design, the control condition will be crossed over to the active treatment, allowing for a replication within the study. The entire treated sample (N = 50) will be compared to a sample (N = 50) receiving strict 12- session protocol-driven CPT through the course of a recent study conducted at the same site using the same primary outcome measures. Participants in the study will be administered a battery of interviews and self-report measures which include 1.) Clinician Administered PTSD Scale, 2.) Structured Clinical Interview for DSM-IV Axis I &II Disorders, 3.) Standardized Trauma Interview, 4.) PTSD Diagnostic Scale, 5.) Beck Depression Inventory - II, 6.) Trauma-Related Guilt Inventory, 7.) Pennebaker Inventory of Limbic Languidness. Subjects will monitor progress through use of daily diaries as well as undergo formal assessments at pre-treatment, at three status checkpoints during therapy, at post-treatment, and at a three month follow-up point. Conducting the proposed study will have important implications on advancing the ecological validity and effectiveness of applied research on PTSD.
