TUESDAY, June 3 (HealthDay News) -- Having recent trauma
survivors relive the troubling event in a controlled environment
may help prevent them from developing post-traumatic stress
disorder (PTSD), according to a new report.
This exposure-based therapy approach is not new, but clinicians
sometime avoid using it under the belief it distresses the
survivors too much, according to background information for the
report, published in the June issue of
Archives of General Psychiatry. Instead, they tend to favor
cognitive restructuring, which focuses on changing thoughts and
responses to a traumatic event.
In an Australian study, 90 patients who developed acute stress
disorder after a non-sexual assault or motor vehicle crash were
randomly assigned to five weekly 90-minute sessions of exposure
therapy or cognitive restructuring, or they were wait-listed for
treatment.
After completing treatment, fewer patients who received exposure
therapy met criteria for PTSD than those in the cognitive
restructuring group (33 percent vs. 63 percent) or the wait-list
group (77 percent). The ratio for exposure therapy versus cognitive
restructuring held fairly closely in a follow-up exam done six
months later; however, 47 percent of the patients getting exposure
therapy had achieved full remission, while only 13 percent of those
in the cognitive restructuring group did.
Despite some concerns that patients may not be able to manage
the distress elicited by prolonged exposure, there was no
difference in drop-out rates for the prolonged exposure and
cognitive restructuring groups (17 percent vs. 23 percent), the
authors wrote. In addition, by the end of three sessions, the
distress ratings were significantly lower in the exposure therapy
group than in the cognitive restructuring group.
Exposure therapy may be more effective than cognitive
restructuring, because it eases the anxiety associated with the
traumatic memory and corrects the belief that the memory must be
avoided, in addition to encouraging self-control, the authors
noted.
The current findings suggest that direct activation of trauma
memories is particularly useful for prevention of PTSD symptoms in
patients with acute stress disorder, the authors concluded.
Exposure should be used in early intervention for people who are at
high risk for developing PTSD.
More information
The U.S. National Institute of Mental Health has more about
post-traumatic stress disorder.
