Imaginal exposure alone and imaginal exposure with cognitive restructuring in treatment of posttraumatic stress disorder.

TLDR

This study investigated whether adding cognitive restructuring to prolonged imaginal exposure would produce greater symptom reduction than imaginal exposure alone in PTSD patients. Fifty‑eight civilian trauma survivors with PTSD were randomized to IE/CR, IE, or supportive counseling, receiving eight weekly individual sessions with extensive homework and assessed before, after, and six months post‑treatment. Both IE/CR and IE reduced PTSD and depression relative to supportive counseling, but IE/CR led to greater reductions in PTSD symptoms and maladaptive cognitions at six‑month follow‑up, indicating that combining CR with IE enhances treatment gains.

Abstract

This study investigated the extent to which providing cognitive restructuring (CR) with prolonged imaginal exposure (IE) would lead to greater symptom reduction than providing IE alone for participants with posttraumatic stress disorder (PTSD). Fifty-eight civilian survivors of trauma with PTSD were randomly allocated to IE/CR, IE, or supportive counseling (SC). Treatment involved 8 individual weekly sessions with considerable homework. Independent assessments were conducted pretreatment, posttreatment, and at 6-month follow-up. IE/CR and IE resulted in reduced PTSD and depression compared with SC at posttreatment and follow-up. Further, IE/CR participants had greater reductions in PTSD and maladaptive cognitive styles than IE participants at follow-up. These findings suggest that providing CR in combination with IE may enhance treatment gains.