TY - JOUR PY - 2021// TI - Cognitive processing therapy for substance-involved sexual assault: does an account help or hinder recovery? JO - Journal of Traumatic Stress A1 - Jaffe, Anna E. A1 - Kaysen, Debra A1 - Smith, Brian N. A1 - Galovski, Tara A1 - Resick, Patricia A. SP - ePub EP - ePub VL - ePub IS - ePub N2 - Sexual assault (SA) often occurs in the context of substances, which can impair the trauma memory and contribute to negative cognitions like self-blame. Although these factors may affect posttraumatic stress disorder (PTSD) treatment, outcomes for substance-involved SA have not been evaluated or compared with other types of SA. As such, we conducted a secondary analysis of a dismantling trial for cognitive processing therapy (CPT), focusing on 58 women with an index trauma of SA that occurred since age 14. Women who experienced a substance-involved SA (n = 21) were compared with those who experienced a non-substance-involved SA (n = 37). Participants were randomized to CPT, CPT with written account (CPT+A), or written account only (WA). Regressions controlling for pretreatment symptom levels revealed no differences by SA type in PTSD severity at posttreatment. At 6-month follow-up, substance-involved SA was associated with more severe residual PTSD severity than non-substance-involved SA, with no significant differences by treatment condition. Among participants in the substance-involved SA group, the largest effect for reduced PTSD symptom severity from pretreatment to follow-up emerged in the CPT condition, d = -2.02, with reductions also observed in the CPT+A, d = -0.92, and WA groups, d = -1.23. Although more research in larger samples is needed, these preliminary findings suggest that following substance-involved SA, a cognitive treatment approach without a trauma account may facilitate lasting change in PTSD symptoms. We encourage replications to better understand the relative value of cognitive and exposure-based treatment for PTSD following substance-involved SAs.

Language: en

LA - en SN - 0894-9867 UR - http://dx.doi.org/10.1002/jts.22674 ID - ref1 ER -