Electronic Theses and Dissertations

Date of Award

2016

Document Type

Dissertation

Degree Name

Ph.D. in Psychology

Department

Psychology

First Advisor

Karen A. Christoff

Second Advisor

Erin Holmes

Third Advisor

Todd A. Smitherman

Relational Format

dissertation/thesis

Abstract

A randomized controlled trial was conducted to test the relative efficacy of a brief directive protocol (DP) aimed at reducing posttraumatic stress disorder (PTSD) symptoms and an expressive writing protocol (EW), which has more than a 30-year history (Pennebaker & Chung, 2011) of research showing mostly positive effects. The DP included components with research support from studies of expressive writing, prolonged exposure, cognitive processing therapy, and mindfulness-based therapies. Participants were primarily undergraduate students at a large public university in the southern United States who endorsed at least one traumatic experience and who manifested a minimal level of PTSD symptoms. The primary outcome measure was the Modified PTSD Symptom Scale-Self Report (MPSS-SR; Falsetti, Resnick, Resick, & Kilpatrick, 1993) with a primary endpoint of 14-days post-treatment and 30-day follow-up for maintenance of symptom reductions. Multilevel mixed effects modeling was used to analyze results. Both treatment conditions shostatistically and clinically significant reductions in PTSD symptoms, with more robust effects associated with the DP condition. Additional analyses shocomparable significant reductions in physical illness symptoms between conditions, and significantly larger reductions of depressive symptoms by the DP condition. The DP condition was also significantly better at reducing thought suppression and rumination, and at increasing cognitive acceptance of the trauma. DP also shosignificant reduction in alexithymia, which was not shown by EW. Assessment of distress levels during the interventions suggest EW achieves reductions in PTSD symptoms through in-session habituation. For the DP condition, participants demonstrated in-session habituation to explicit emotion cues but not to the trauma itself; however, other evidence also suggests habituation. Recommendations are offered regarding use of these protocols and further study of effective components.

Concentration/Emphasis

Emphasis: Clinical Psychology

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