Mechanisms of Change in Written Exposure Treatment of Posttraumatic Stress Disorder

Behavior Therapy
Blair E WiscoDenise M Sloan

Abstract

Although the effectiveness of exposure therapy for PTSD is recognized, treatment mechanisms are not well understood. Emotional processing theory (EPT) posits that fear reduction within and between sessions creates new learning, but evidence is limited by self-report assessments and inclusion of treatment components other than exposure. We examined trajectories of physiological arousal and their relation to PTSD treatment outcome in a randomized controlled trial of written exposure treatment, a protocol focused on exposure to trauma memories. Hierarchical linear modeling was used to model reduction in Clinician Administered PTSD Scale score as a predictor of initial activation and within- and between-session change in physiological arousal. Treatment gains were significantly associated with initial physiological activation, but not with within- or between-session changes in physiological arousal. Treatment gains were associated with larger between-session reductions in self-reported arousal. These findings highlight the importance of multimethod arousal assessment and add to a growing literature suggesting refinements of EPT.

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Citations

Apr 16, 2016·Contemporary Clinical Trials·Denise M SloanPatricia A Resick
Sep 28, 2016·Current Psychiatry Reports·Rebecca K SripadaIsrael Liberzon
Jun 28, 2019·Current Treatment Options in Psychiatry·Johanna Thompson-HollandsDenise M Sloan
May 19, 2020·Current Treatment Options in Psychiatry·Nicholas A LivingstonJillian C Shipherd
Jul 19, 2017·Borderline Personality Disorder and Emotion Dysregulation·Nora GörgNikolaus Kleindienst

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