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Treatment for PTSD related to childhood abuse: a randomized controlled trial.

Publication ,  Journal Article
Cloitre, M; Stovall-McClough, KC; Nooner, K; Zorbas, P; Cherry, S; Jackson, CL; Gan, W; Petkova, E
Published in: Am J Psychiatry
August 2010

OBJECTIVE: Posttraumatic stress disorder (PTSD) related to childhood abuse is associated with features of affect regulation and interpersonal disturbances that substantially contribute to impairment. Existing treatments do not address these problems or the difficulties they may pose in the exploration of trauma memories, an efficacious and frequently recommended approach to resolving PTSD. The authors evaluated the benefits and risks of a treatment combining an initial preparatory phase of skills training in affect and interpersonal regulation (STAIR) followed by exposure by comparing it against two control conditions: Supportive Counseling followed by Exposure (Support/Exposure) and skills training followed by Supportive Counseling (STAIR/Support). METHOD: Participants were women with PTSD related to childhood abuse (N=104) who were randomly assigned to the STAIR/Exposure condition, Support/Exposure condition (exposure comparator), or STAIR/Support condition (skills comparator) and assessed at posttreatment, 3 months, and 6 months. RESULTS: The STAIR/Exposure group was more likely to achieve sustained and full PTSD remission relative to the exposure comparator, while the skills comparator condition fell in the middle (27% versus 13% versus 0%). STAIR/Exposure produced greater improvements in emotion regulation than the exposure comparator and greater improvements in interpersonal problems than both conditions. The STAIR/Exposure dropout rate was lower than the rate for the exposure comparator and similar to the rate for the skills comparator. There were significantly lower session-to-session PTSD symptoms during the exposure phase in the STAIR/Exposure condition than in the Support/Exposure condition. STAIR/Exposure was associated with fewer cases of PTSD worsening relative to both of the other two conditions. CONCLUSIONS: For a PTSD population with chronic and early-life trauma, a phase-based skills-to-exposure treatment was associated with greater benefits and fewer adverse effects than treatments that excluded either skills training or exposure.

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Published In

Am J Psychiatry

DOI

EISSN

1535-7228

Publication Date

August 2010

Volume

167

Issue

8

Start / End Page

915 / 924

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Stress Disorders, Post-Traumatic
  • Social Support
  • Risk Assessment
  • Psychiatry
  • Interpersonal Relations
  • Implosive Therapy
  • Humans
  • Female
  • Counseling
 

Citation

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ICMJE
MLA
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Cloitre, M., Stovall-McClough, K. C., Nooner, K., Zorbas, P., Cherry, S., Jackson, C. L., … Petkova, E. (2010). Treatment for PTSD related to childhood abuse: a randomized controlled trial. Am J Psychiatry, 167(8), 915–924. https://doi.org/10.1176/appi.ajp.2010.09081247
Cloitre, Marylene, K Chase Stovall-McClough, Kate Nooner, Patty Zorbas, Stephanie Cherry, Christie L. Jackson, Weijin Gan, and Eva Petkova. “Treatment for PTSD related to childhood abuse: a randomized controlled trial.Am J Psychiatry 167, no. 8 (August 2010): 915–24. https://doi.org/10.1176/appi.ajp.2010.09081247.
Cloitre M, Stovall-McClough KC, Nooner K, Zorbas P, Cherry S, Jackson CL, et al. Treatment for PTSD related to childhood abuse: a randomized controlled trial. Am J Psychiatry. 2010 Aug;167(8):915–24.
Cloitre, Marylene, et al. “Treatment for PTSD related to childhood abuse: a randomized controlled trial.Am J Psychiatry, vol. 167, no. 8, Aug. 2010, pp. 915–24. Pubmed, doi:10.1176/appi.ajp.2010.09081247.
Cloitre M, Stovall-McClough KC, Nooner K, Zorbas P, Cherry S, Jackson CL, Gan W, Petkova E. Treatment for PTSD related to childhood abuse: a randomized controlled trial. Am J Psychiatry. 2010 Aug;167(8):915–924.
Journal cover image

Published In

Am J Psychiatry

DOI

EISSN

1535-7228

Publication Date

August 2010

Volume

167

Issue

8

Start / End Page

915 / 924

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Stress Disorders, Post-Traumatic
  • Social Support
  • Risk Assessment
  • Psychiatry
  • Interpersonal Relations
  • Implosive Therapy
  • Humans
  • Female
  • Counseling