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Harm expectancy violation during exposure therapy for posttraumatic stress disorder.
Rianne A de Kleine1, Lotte Hendriks2, Eni S Becker3
1Institute of Psychology, Leiden University, The Netherlands; Center for Anxiety Disorders Overwaal, Institution for Integrated Mental Health Care Pro Persona, Nijmegen, The Netherlands.
Journal of Anxiety Disorders
|April 12, 2017
Summary
Exposure therapy for posttraumatic stress disorder (PTSD) violates harm expectancies but does not improve symptoms. Fear habituation, not expectancy violation, moderately relates to PTSD symptom reduction.
Area of Science:
- Psychology
- Clinical Psychology
- Trauma Studies
Background:
- Exposure therapy is effective for PTSD.
- Emotional processing theory suggests fear habituation reduces PTSD symptoms.
- Violation of harm expectancies is a proposed mechanism in exposure therapy.
Purpose of the Study:
- To investigate harm expectancy violation as a mechanism of change in exposure therapy for PTSD.
- To examine changes in harm expectancies during exposure therapy.
- To determine the relationship between harm expectancy violation and PTSD symptom reduction.
Main Methods:
- Fifty patients with chronic PTSD received intensive exposure therapy.
- Harm expectancies, harm experiences, and distress (SUDs) were assessed during imaginal exposure.
- PTSD symptoms were measured pre- and posttreatment using the CAPS.
Main Results:
- Harm expectancies were violated during and decreased between exposure sessions.
- Expectancy violation did not correlate with PTSD symptom change.
- Fear habituation measures showed a moderate relationship with PTSD symptom reduction.
Conclusions:
- Exposure therapy leads to harm expectancy violation in PTSD patients.
- Harm expectancy violation is not directly linked to PTSD symptom improvement.
- Further research is needed to understand exposure therapy mechanisms in PTSD.
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