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Not all patients with posttraumatic stress disorder benefit from exposure treatment. The present paper describes two cognitive dimensions that are related to inferior response to exposure in rape victims. First, individuals whose memories during relieving of the trauma reflected mental defeat or the absence of mental planning showed little improvement. Second, inferior outcome was correlated with an overall feeling of alienation or permanent change following the trauma. These results are based on blind ratings of transcripts of exposure treatment sessions from 10 women with good outcome and 10 women with inferior outcome. Patients in the two groups were matched for initial symptom severity and were comparable in many aspects of the assault. Patients who experienced mental defeat, alienation, or permanent change may require cognitive restructuring in addition to exposure.

Original publication

DOI

10.1023/A:1024448511504

Type

Journal article

Journal

J Trauma Stress

Publication Date

07/1998

Volume

11

Pages

457 - 471

Keywords

Adult, Desensitization, Psychologic, Female, Humans, Mental Recall, Middle Aged, Motivation, Personality Inventory, Prognosis, Rape, Social Alienation, Stress Disorders, Post-Traumatic, Treatment Outcome