Treatment for women with PTSD related to childhood abuse

January 01, 0001

Treatment for women with PTSD related to childhood abuse

Posttraumatic stress disorder (PTSD) related to childhood abuse is associated with features of affect regulation and interpersonal disturbances that substantially contribute to impairment. These US authors evaluated the benefits and risks of a treatment combining an initial preparatory phase of skills training in affect and interpersonal regulation (STAIR) followed by exposure and compared against two control conditions: Supportive Counseling followed by Exposure (Support/Exposure) and skills training followed by Supportive Counseling (STAIR/Support). Participants were women with PTSD related to childhood abuse (N=104) and assessed at posttreatment, 3 months, and 6 months.

They found: "The STAIR/Exposure group was more likely to achieve sustained and full PTSD remission relative to the exposure comparator, while the skills comparator condition fell in the middle (27% versus 13% versus 0%). STAIR/Exposure produced greater improvements in emotion regulation than the exposure comparator and greater improvements in interpersonal problems than both conditions. The STAIR/Exposure dropout rate was lower than the rate for the exposure comparator and similar to the rate for the skills comparator. There were significantly lower session-to-session PTSD symptoms during the exposure phase in the STAIR/Exposure condition than in the Support/Exposure condition. STAIR/Exposure was associated with fewer cases of PTSD worsening relative to both of the other two conditions."

The authors concluded: "For a PTSD population with chronic and early-life trauma, a phase-based skills-to-exposure treatment was associated with greater benefits and fewer adverse effects than treatments that excluded either skills training or exposure."

Skills training in affect and interpersonal regulation followed by exposure therapy seems to be the best approach for women with PTSD related to childhood abuse.

For the full abstract, click here.

Am J Psychiatry 167:915-924, September 2010
© 2010 American Psychiatric Association
Treatment for PTSD Related to Childhood Abuse: A Randomized Controlled Trial. Marylene Cloitre, K. Chase Stovall-McClough, Kate Nooner, et al. Correspondence to Dr. Cloitre: [email protected]

Category: P. Psychological. Keywords: posttraumatic stress disorder, PTSD, women, childhood abuse, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo Ohio. Posted on Global Family Doctor 21 September 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.