Changes in reported physical health symptoms and social function with prolonged exposure therapy for chronic posttraumatic stress disorder

Abstract

Background : Postraumatic stress disorder (PTSD) is associated with significant health risk, illness, and functional impairment, e.g., Green and Kimerling [2004: Physical Health Consequences of Exposure to Extreme Stress. Washington, DC: American Phychological Association] Kimerling et al. [2000: Trauma and Health: J Trauma Stress 13:115–128]. Methods : These analyses examined whether negative health perceptions and general social functioning change with treatment of chronic PTSD among women from a randomized controlled study comparing prolonged exposure (PE; n =48) or PE combined with cognitive restructuring (PE/CR; n =40) to waitlist ( n =19; Foa et al., 2005: J Consult Clin Psychol 73:953–964]. Results : Self- reported physical health difficulties were significantly reduced in the PE and PE/CR conditions compared to the waitlist condition. These reductions did not demonstrate significant change during the 12 month follow-up period. Self-reported discomfort associated with physical health difficulties did not demonstrate significant change over treatment. No difference was detected between the active treatment and waitlist conditions. Both the PE and PE/CR groups reported improved social functioning at post treatment compared to the waitlist. Additional improvement in general social functioning was found between 3 and 12 month follow-up assessments. Changes in PTSD and depressive symptoms over treatment accounted for 29% of the variance in reduction of reported health problems and 30% of the variance in improvement of general social functioning. Importantly, only changes in PTSD symptoms significantly contribute to the model predicting change in physical health problems with depression associated only at a trend level. However, collinearity between PTSD and depression makes interpretation difficult. Conclusions : Negative health perceptions and general social function improve with PE. Changes in depression and PTSD with treatment are related to these changes. Depression and Anxiety, 2009. © 2008 Wiley-Liss, Inc.