Symptom exacerbations in trauma-focused treatments: Associations with treatment outcome and non-completion
Section snippets
Participants
This study combined data from two randomized controlled trials of cognitive-behavioral therapy for PTSD with female victims of interpersonal violence (Resick et al., 2008, Resick et al., 2002). The first study compared CPT, PE, and a wait-list condition; those in the wait-list were randomly assigned to either CPT or PE after 6 weeks. The second study was a dismantling study comparing full CPT to its components: a written account only condition and a cognitive therapy only condition (CPT-C).
Symptom exacerbation frequencies: comparison across conditions
In this sample, a nontrivial minority of patients experienced a symptom exacerbation at some point in the treatment (CPT = 28.6% at any point, 13.4% at session 4; CPT-C = 14.7% at any point, 2.9% at session 4; and PE = 20.0% at any point, 15% at session 4). See Table 1 for the numbers and percentages of participants experiencing an exacerbation at each session.2
Discussion
This study examined whether trauma-focused treatments were associated with symptom exacerbations. Results are similar to those found by Foa et al. (2002), with remarkably similar percentages of participants experiencing session 4 exacerbations in both studies, despite differences in methodology (i.e., weekly sessions in Foa et al. vs. twice weekly sessions in these studies). Further extending the literature on symptom exacerbations, we also examined symptom exacerbations at any point in
Conflicts of interest
None.
Financial support
None.
Acknowledgments
This manuscript was funded by NIMH grants #1-R01-MH51509 and 2-R01-MH51509 awarded to Patricia Resick. It is partially the result of work supported with resources and the use of facilities at the Clement J. Zablocki VAMC, Milwaukee, WI.
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