Exposure in the treatment of posttraumatic stress disorder

Theron, Johanna Christina (2007-12)

Dissertation (DPhil) -- University of Stellenbosch, 2007.

Thesis

ENGLISH ABSTRACT: A review of the literature revealed that several well-controlled outcome studies found prolonged exposure effective in the treatment of posttraumatic stress disorder (PTSD). However, all these studies were based on either American or British samples. The present study, therefore, investigated the effectiveness of exposure treatment for PTSD in a South African sample of female survivors of sexual violence. Fifteen patients participated in manualized exposure treatment, consisting of nine sessions of 90 minutes each, while 14 patients served as delayed treatment controls. Results showed that prolonged exposure significantly reduced all the PTSD symptom clusters (re-experiencing, avoidance, and arousal) from pretreatment to post-treatment, and that this improvement was maintained at followup after three months. At the end of treatment no treated patient met the diagnostic criteria for PTSD, as assessed by an independent, blind evaluator by means of the Clinician Administered PTSD Scale. The untreated controls all retained the diagnosis of PTSD. The results also showed a gradual reduction in posttraumatic stress symptoms and the associated symptoms of depression, anxiety and dysfunctional cognitions from sessions two to four, again from four to six, and again from sessions six to eight. In addition, based on four case studies, there were indications that prolonged exposure treatment also facilitated a reduction in regional cerebral blood flow (rCBF) bilaterally in the superior and mid frontal regions, as well as mixed bilateral changes in perfusion in the cerebellum and parietooccipital regions.

AFRIKAANSE OPSOMMING: Uit 'n oorsig van die literatuur blyk dit dat verskeie goed gekontroleerde uitkomsstudies aangetoon het dat langdurige blootstelling 'n effektiewe behandelingsprosedure vir posttraumatiese stresversteuring (PTSV) is. Omdat al hierdie studies egter op Amerikaanse of Britse steekproewe gebaseer was, het die huidige studie ten doel gehad om die effektiwiteit van langdurige blootstelling in 'n Suid-Afrikaanse steekproef van vroulike slagoffers van PTSV as gevolg van seksuele geweld te ondersoek. Vyftien pasiente het deelgeneem aan 'n handleidingsgebaseerde blootstellingsprogram bestaande uit nege sessies van 90 minute elk, terwyl 14 pasiente in 'n vertraagde behandeling kontrolegroep ingesluit is. Die resultate het aangetoon dat langdurige blootstelling al die PTSV simptoomgroepe beduidend van voor tot na behandeling verminder het, en dat hierdie verbetering gehandhaaf is by opvolg drie maande na behandeling. Aan die einde van die behandeling het geen van die behandelde pasiente meer aan die diagnostiese kriteria vir PTSV voldoen nie, terwyl die pasiente in die kontrolegroep alma! die diagnose behou het. Die resultate het ook aangetoon dat daar 'n geleidelike verbetering in posttraumatiese stressimptome sowel as die geassosieerde simptome van depressie, angs en disfunksionele kognisies vanaf sessies twee na vier, weer van vier na ses, en weer vanaf sessies ses na agt plaasgevind het. Hierbenewens het dit ook op grond van vier gevallestudies geblyk dat langdurige blootstelling 'n vermindering in serebrale streekbloedvloei bilateraal in die superior en mid-frontale areas, sowel as gemengde bilaterale veranderinge in perfusie in die serebellum en parieto-oksipitale areas gefasiliteer het.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/50714
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