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Related Experiment Videos

Does imaginal exposure exacerbate PTSD symptoms?

Edna B Foa1, Lori A Zoellner, Norah C Feeny

  • 1Center for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia 19104, USA. foa@mail.med.upenn.edu

Journal of Consulting and Clinical Psychology
|August 17, 2002
PubMed
Summary
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Symptom exacerbation during prolonged exposure therapy for posttraumatic stress disorder (PTSD) is uncommon. This temporary increase in symptoms did not negatively impact treatment outcomes or lead to dropout in women with chronic PTSD.

Area of Science:

  • Psychotherapy Research
  • Trauma and Mental Health

Background:

  • Symptom exacerbation, or treatment side effects, is under-researched in psychotherapy.
  • Prolonged exposure therapy is empirically supported for chronic posttraumatic stress disorder (PTSD).
  • Concerns exist that imaginal exposure within this therapy may worsen symptoms, affecting outcomes or dropout.

Purpose of the Study:

  • To investigate the occurrence and impact of symptom exacerbation in women undergoing prolonged exposure for chronic PTSD.
  • To define reliable symptom exacerbation using statistical measures.

Main Methods:

  • Examined symptom exacerbation in 76 women with chronic PTSD.
  • Defined "reliable" exacerbation using standard deviation and test-retest reliability of outcome measures.
  • Analyzed the relationship between symptom exacerbation, treatment outcomes, and dropout rates.

Related Experiment Videos

Main Results:

  • A minority of participants experienced reliable symptom exacerbation.
  • Individuals with symptom exacerbation showed comparable treatment benefits.
  • Symptom exacerbation was not associated with patient dropout.

Conclusions:

  • Temporary symptom exacerbation is infrequent in prolonged exposure therapy for chronic PTSD.
  • Symptom exacerbation does not appear to negatively influence treatment outcomes or adherence.
  • Findings suggest imaginal exposure is safe and effective for chronic PTSD, despite potential transient symptom increases.