CHANGES IN REPORTED PHYSICAL HEALTH SYMPTOMS AND SOCIAL FUNCTION WITH PROLONGED EXPOSURE THERAPY FOR CHRONIC POSTTRAUMATIC STRESS DISORDER

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: F 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:,7 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 26.732-738, 2009. (C) 2008 Wiley-Liss, Inc.