Trauma and women: Course, predictors, and treatment

Posttraumatic stress disorder (PTSD) resulting from aggravated assault, rape, or noncrime trauma affects over 4 million women in the United States, according to retrospective studies. Prospective studies reviewed here found that 3 months post assault the prevalence of PTSD was 48% in rape victims and 25% in nonsexual crime victims. Prolonged exposure treatment and stress inoculation training are both effective psychotherapeutic treatments for PTSD. Prolonged exposure involves having the patient relive the traumatic memory and recount the event in detail. This description is audiotaped and the patient is asked to listen to it as part of assigned homework. In vivo exposure to feared objects or situations is also assigned as homework. Stress inoculation training consists of teaching patients a variety of techniques for managing anxiety, including controlled breathing, deep muscle relaxation, thought-stopping, cognitive restructuring, preparation for stressors, covert modeling, and role-play. Both treatments have been proven to be effective alone and in combination in ameliorating chronic PTSD in women after traumatic sexual or nonsexual assault. This efficacy was maintained for 3 months of follow-up.
Foa,Edna B.
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Journal of Clinical Psychiatry
This study addresses the need for effective short-term treatments for women in the United States who have post traumatic stress disorder (PTSD) resulting from aggravated assault, rape, or non-crime trauma. This article also discusses two cognitive behavioral treatments for PTSD: prolonged exposure treatment and stress inoculation training programs. A study involving 96 female victims of sexual or aggravated assault (who met the diagnostic criteria for PTSD) was conducted to compare the efficacy of these two therapies. Stress inoculation training, prolonged exposure, and the combination of both showed immediate as well as long-term (6-month) treatment effects when compared to the control group. Prolonged exposure treatment appeared to be superior overall. The article includes a discussion of how these therapies can prevent PTSD from becoming chronic.
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