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Cognitive therapy or imaginal exposure in the treatment of post-traumatic stress disorder

Twelve-month follow-up

Published online by Cambridge University Press:  03 January 2018

Nicholas Tarrier ,
Claire Sommerfeld ,
Hazel Pilgrim  and
Lloyd Humphreys
Nicholas Tarrier*
Affiliation:
Department of Clinical Psychology, School of Psychiatry and Behavioural Science, University of Manchester
Claire Sommerfeld
Affiliation:
Department of Clinical Psychology, School of Psychiatry and Behavioural Science, University of Manchester
Hazel Pilgrim
Affiliation:
Department of Clinical Psychology, School of Psychiatry and Behavioural Science, University of Manchester
Lloyd Humphreys
Affiliation:
Department of Clinical Psychology, School of Psychiatry and Behavioural Science, University of Manchester
*
Professor N. Tarrier, Department of Clinical Psychology, Withington Hospital, Manchester M20 8LR. Tel: 0161-291 4319; Fax: 0161-291 3814; e-mail: ntarrier@fsl.with.man.ac.uk
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Abstract

Background

Previously reported results have demonstrated the efficacy of exposure and cognitive therapy in the treatment of chronic post-traumatic stress disorder (PTSD), but have not shown one to be superior to the other.

Aims

To investigate whether treatment benefits and equivalence are maintained at 12-month follow-up in patients with chronic PTSD treated with either imaginai exposure or cognitive therapy.

Method

Twelve-month follow-up of a randomised clinical trial.

Results

Fifty-four subjects (87% of the sample) were available to follow-up. They did not significantly differ clinically from drop-outs. There was significant clinical improvement at 12 months compared with pre-treatment. However, 39% of those followed-up still met criteria for PTSD. There were no significant differences between the two treatments. Victims of crime displayed higher levels of symptoms at follow-up than victims of accidents.

Conclusions

Clinical benefits for exposure or cognitive therapy were maintained.

Type
Papers
Information
The British Journal of Psychiatry , Volume 175 , Issue 6 , December 1999 , pp. 571 - 575
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

Declaration of interest

The research was supported by a project grant from the Wellcome Trust.

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.Google Scholar
Beck, A. T. (1988) Beck Depression inventory New York: Psychological Corporation.Google Scholar
Beck, A. T. (1990) Beck Anxiety Inventory New York: Psychological Corporation.Google Scholar
Beck, A. T. & Emery, G., (1985) Anxiety Disorders and Phobias. New York: Basic Books.Google Scholar
Blake, D. Weathers, F., Nogy, F., et al (1990) A clinician rating scale for assessing current and lifetime PTSD: the CAPS–I. Behavior Therapist, 13, 187 188.Google Scholar
Cooper, N. A. & Clum, G. A. (1989) Imaginal flooding as a supplementary treatment for PTSD in combat veterans: a controlled trial. Behavior Therapy, 20, 381–391.CrossRefGoogle Scholar
Foa, E. B., Rothbaum, B. O., Riggs, D. S., et al (1991) Treatment of posttraumatic stress disorder in rape victims: a comparison between cognitive–behavioral procedures and counseling. Journal of Consulting and Clinical Psychology, 59, 715–723.CrossRefGoogle ScholarPubMed
Foa, E. B., Dancu, C. V., Hembree, E. A., et al (1999) A comparison of exposure therapy, stress inoculation training, and their combination for reducing posttraumatic stress disorder in female assault victims. Journal of Consulting and Clinical Psychology, 67, 194–201.CrossRefGoogle ScholarPubMed
Goldberg, D. & Williams, P. (1988) A User's Guide to the General Health Questionnaire. Windsor: NFER–Nelson.Google Scholar
Hammarberg, M. (1992) Penn Inventory for posttraumatic stress disorder: psychometric properties. Psychological Assessment, 4, 67–76.CrossRefGoogle Scholar
Horowitz, M. J., Wilner, N. & Alvarez, W. (1979) Impact of events scale: a measure of subjective stress. Psychosomatic Medicine, 41, 209–218.CrossRefGoogle Scholar
Keane, T. M., Falrbank, J. A., Caddall, J. M., et al (1989) Implosive (flooding) therapy reduces symptoms of PTSD in Vietnam combat veterans. Behavior Therapy, 20, 245–260.CrossRefGoogle Scholar
Marks, I., Lovell, K., Noshirvani, H., et al (1998) Exposure and cognitive restructuring alone and combined in PTSD: a controlled study. Archives of General Psychiatry, 55, 317–325.CrossRefGoogle ScholarPubMed
Pitman, R. K., Altman, B., Greenwald, E., et al (1991) Psychiatric complications during flooding therapy for posttraumatic stress disorder. Journal of Clinical Psychiatry, 52, 17–20.Google ScholarPubMed
Resick, P. A. & Schnicke, M. K. (1992) Cognitive processing therapy for sexual assault victims. Journal of Consulting and Clinical Psychology, 60, 748–756.CrossRefGoogle ScholarPubMed
Scott, M., J. & Stradling, S. G. (1997) Client compliance with exposure for post-traumatic stress disorder. Journal of Traumatic Stress, 10, 523 526.CrossRefGoogle Scholar
Tarrier, N., Pilgrim, H., Sommerfield, C., et al (1999a) A randomized trial of cognitive therapy and imaginai exposure in the treatment of chronic posttraumatic stress disorder. Journal of Consulting and Clinical Psychology 67, 13–18.CrossRefGoogle Scholar
Tarrier, N., Sommerfield, C., Reynolds, M., et al (1999b) Symptom self-monitoring in the treatment of posttraumatic stress disorder. Behaviour Therapy, in press.CrossRefGoogle Scholar
Tarrier, N., Sommerfield, C., Pilgrim, H., et al (1999c) Factors associated with outcome of cognitive behavioral treatment of chronic posttraumatic stress disorder. Behaviour Research and Therapy, in press.CrossRefGoogle Scholar
Tarrier, N., Sommerfield, C. & Pilgrim, H. (1999d) The effect of the relatives' level of expressed emotion (EE) on the outcome of psychological treatment of PTSD patients. Psychological Medicine, 29, 801–811.CrossRefGoogle Scholar
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