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Treating PTSD in Rape

Survivors
Marcella Petrini
Wake Forest University
Introduction
According to DSM-IV-TR, PTSD:
Persistently
Re-experiences event
Avoidance of associated stimuli
Symptoms of increased arousal
Duration for more than one month
2/3 American men and American
women have experienced at least one
trauma (Kimerling, Ouimette, & Wolfe, 2002)
Women twice as likely to develop PTSD
when compared to men (Kessler, Sonnega, & Brome, 1995)

Introduction
Women10 times more likely to be
sexually assaulted in comparison to
men (Jaycox, Zoellner, & Foa, 2002)
Estimated that one in four women will
be raped during lifetime (Foa, Rothbaum, Riggs, & Murdock,
1991)
Pervasive issuehow do we treat?
Methods
ZSR Library search engine
EBSCO, PsychINFO, and Wiley
Online Library
women and PTSD, rape and
PTSD, and cognitive-behavioral
therapy and rape
Reference lists

Results
Cognitive-Behavioral Therapy (CBT)
Most studied treatment in relation to rape
PTSD
Involves:
Prolonged Exposure (PE)
Imaginal exposure
Real-life exposure
Stress Inoculation Therapy (SIT)
Cognitive restructuring
Supported that rape victims need more than
supportive counseling;
SIT found to be more effective short-term; PE
better in long-term follow up (Foa, Rothbaum, Riggs, & Murdock,
1991)
Results
In a combination study, PE-SIT not shown
to be more effective than PE or SIT
separately
PE found to be superior treatment (Foa et al. 1999)
Cognitive Processing Therapy (emphasis
on writing/ emotional processing) shown
to be as effective as PE (Resick et al., 2002)
Results
EMDR
Previously mixed results concerning
effectiveness of EMDR with PTSD
In a comparison of PE and EMDR with
rape victims, both demonstrated
significant improvement
In follow-up, PE group had better end-state
functioning (Rothbaum et al., 2005)
Results
Online Treatment
Pilot study; attempt to account for
survivors who did not initially want to seek
treatment
Therapist-facilitated, self-paced CBT
program
Video clips describing CBT exercises,
therapist written responses
Suggested as helpful for rape victims for
PTSD, but not for general distress (Littleton, Buck,
Rosman, & Grills-Taquechel 2012)
Discussion
Prolonged exposure shown as most
efficacious overall
With SIT, CPT, and EMDR
demonstrated as effective, further
research needed to match clients with
treatments
Long-term effects of treatments needs
more research
More extensive research with EMDR
and rape PTSD

Discussion
Explore why women drop out of
treatment (Foa et al., 1999; Resick et al. 2002)
Expansion of pilot online treatment;
combine with other treatments and
compare it with face-to-face therapy
Relating research about PTSD rape
treatments to men
References
Foa, E. B., Dancu, C. V., Hembree, E. A., Jaycox, L. H., Meadows, E. A., & Street, G. P.
(1999). A comparison of exposure therapy, stress inoculation training, and their
combination for reducing posttraumatic stress disorder in female assault
victims. Journal of Consulting and Clinical Psychology, 67(2), 194200.
doi:10.1037/0022-006X.67.2.194
Foa, E. B., Rothbaum, B. O., Riggs, D. S., & Murdock, T. B. (1991). Treatment of
posttraumatic stress disorder in rape victims: A comparison between cognitive-
behavioral procedures and counseling. Journal of Consulting and Clinical
Psychology, 59(5), 715723. doi:10.1037/0022- 006X.59.5.715
Jaycox, L. H., Zoellner, L., & Foa, E. B. (2002). Cognitivebehavior therapy for PTSD in
rape survivors. Journal of Clinical Psychology, 58(8), 891906. doi:10.1002/jclp.10065
Littleton, H., Buck, K., Rosman, L., & Grills-Taquechel, A. (2012). From Survivor to
Thriver: A pilot study of an online program for rape victims. Cognitive and Behavioral
Practice, 19(2), 315 327. doi:10.1016/j.cbpra.2011.04.002
Resick, P. A., Nishith, P., Weaver, T. L., Astin, M. C., & Feuer, C. A. (2002). A comparison
of cognitive- processing therapy with prolonged exposure and a waiting condition
for the treatment of chronic posttraumatic stress disorder in female rape victims.
Journal of Consulting and Clinical Psychology, 70(4), 867879. doi:10.1037/0022-
006X.70.4.867
Rothbaum, B. O., Astin, M. C., & Marsteller, F. (2005). Prolonged Exposure versus Eye
Movement Desensitization and Reprocessing (EMDR) for PTSD rape victims.
Journal of Traumatic Stress, 18(6), 607.

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