Effects of emotional engagement and habituation on exposure therapy for PTSD

Abstract

Exposure therapy is now considered the first line of treatment for Post Traumatic Stress Disorder (Foa, Davidson, & Frances, 1999). Over the past decade, many studies have illustrated its effectiveness in treating patients with PTSD (Boudewyns & Hyer, 1990; Cooper & Clum, 1989; Foa et al., 1999; Marks, Lovell, Noshirvani, Livanou, & Thrasher, 1998; Tarrier et al., 1999). More recently, trauma theorists have explored uncovering how and why exposure therapy is so effective.;Compelling arguments have been made that two process variables, emotional engagement and habituation, mediate successful outcome of exposure therapy (Jaycox, Foa, & Morral, 1998; van Minnen & Hagenaars, 2002). However, to date, there have been few studies that explore this. The present investigation will examine the effects of emotional engagement and habituation on exposure therapy for PTSD in a sample of trauma patients. It was hypothesized that (1) emotional engagement at the beginning of exposure therapy will predict a decrease in PTSD symptoms over the course of treatment, and (2) habituation across sessions will predict a decrease in PTSD symptoms over the course of treatment.;Eighteen adults diagnosed with PTSD received cognitive-behavioral that involved reliving their trauma, and rated their distress at 5-minute intervals (SUDS). Significant improvement on all PTSD measures was found at the end of treatment. The results suggest that emotional engagement and habituation during exposure therapy is important for treatment success. Consistent relationships between SUDS levels and measures for PTSD and depression outcome scores exist for all types of sessions (first session, mean across 4 sessions, and final session). SUDS levels during the first exposure session appear to the most predictive based on Cohens medium effect size (.3 or better). The higher the level of emotional engagement and habituation in the first session, the lower the symptom levels at outcome.