A Comparison of Exposure
Therapy, Stress Inoculation Training, and Their Combination for Reducing
Posttraumatic Stress Disorder in Female Assault Victims
from an article of the same title by:
Edna B. Foa, Constance V. Dancu, Elizabeth A. Hembree, Lisa H. Jaycox, Elizabeth A. Meadows, and Gordon P. Street, Medical College of Pennsylvania-Hahnemann University
What questions does this study address?
The primary questions in the study are
*Note: This study modified SIT protocol by excluding elements it has
in common with PE.
Other combination treatments such as cognitive processing therapy (CPT) that combine education, cognitive restructuring and exposure techniques have shown effectiveness in reducing symptoms of PTSD and accompanying depression.
Why is this important?
Two major categories of PTSD treatments exist today: exposure therapies and anxiety management programs. This study uses prolonged exposure (PE) and stress inoculation training (SIT) to represent the two categories of treatment, respectively. Differences in effectiveness exist between PTSD treatments: in producing immediate and long-term improvements and in reducing symptoms of accompanying disorders such as anxiety and depression. Informed treatment planning for trauma survivors requires that clinicians understand the differences PTSD treatments produce when used alone or in combination.
How do the different treatments in the study work?
In prolonged exposure (PE) clients relive traumatic memories by recounting traumatic experiences in session. They are also taught how to confront situations in real life that are intensely distressing reminders of the trauma but which are realistically not dangerous or threatening.
Stress inoculation training teaches trauma survivors how to cope with anxiety using techniques such as relaxation training, cognitive restructuring and positive self-talk.
What did the study find?
Active treatment of posttraumatic stress disorder in female assault victims is superior to no treatment (waiting list condition) in reducing symptoms and improving quality of life in these trauma survivors.
More specifically, among treatment participants (PE, SIT or PE+SIT)
The study's results did not support the hypothesis that a combination treatment, PE+SIT, would be more effective than either treatment alone.
The study found that prolonged exposure (PE) treatment participants:
What else from this study might be important to treatment providers?
Treatment providers are cautioned to conclude overall PE superiority. Several factors in the present study may have elevated the effects of PE and suppressed the efficacy of the SIT and PE+SIT treatment conditions:
Reviewed by: Priscilla Schulz, LCSW, July 1999