This proposal seeks to increase the effectiveness of an existing treatment strategy,
cognitive processing therapy (CPT), for the remediation of Posttraumatic Stress Disorder
among crime victims by varying the duration and content of the intervention in accordance
with participants' needs. A secondary goal is to identify predictors of duration of
treatment necessary to achieve good end state functioning, including individual and trauma
variables, cognitive and emotional variables, and Axis II pathology. Finally, by including
a sample of male participants, the generalizability of CPT will be tested. It is anticipated
that these modifications will speed the dissemination of CPT to community practice thus
benefiting more trauma victims. Fifty subjects will be randomly assigned to either the
modified CPT condition or to a symptom-monitoring, minimal attention condition designed to
control for the effects of the daily monitoring and the passage of time. Utilizing a
semicrossover design, the control condition will be crossed over to the active treatment,
allowing for a replication within the study. The entire treated sample (N = 50) will be
compared to a sample (N = 50) receiving strict 12-session protocol-driven CPT through the
course of a recent study conducted at the same site using the same primary outcome measures.
Conducting the proposed study will have important implications on advancing the ecological
validity and effectiveness of applied research on PTSD.
- Participants will be survivors of interpersonal assault, who are at least three
months post-crime at the time of their participation and who meet criteria for a
diagnosis of PTSD. There is no upper time limit on time since crime for
- Exclusion criteria for participants include psychosis, mental retardation, active
suicidality, parasuicidality, or current addiction to drugs or alcohol. In the case
of apparent illiteracy, we will try to accommodate the individual as much as possible
to maximize success in the program. In addition, participants cannot be in a
currently abusive relationship or being stalked. For marital rape or domestic
violence, the participant must have been out of the relationship for at least three
months. Participants may continue the use of any medications throughout the study.
However, participants must be willing to keep the medication usage stable for the
duration of the study and must be stabilized on any new medication for one month
prior to initial assessment. Participants will sign a contract to this effect. All
medication use will be tracked throughout the course of the study on the daily
symptom monitoring diaries, including over the counter medications. Finally,
participants can have received any therapy in the past with the exception of CPT.
They may be receiving concurrent therapy as long as it is not trauma-focused.
Allowing subjects to continue with concurrent therapy offers them the option to
continue with established supports and more closely mimics clinical practice and the
generalizability of the results.
Tara Galovski, PhD
Center for Trauma Recovery, University of Missouri- St. Louis