Publications (4)11.78 Total impact
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Article: Co-occurring posttraumatic stress and depression symptoms after sexual assault: A latent profile analysis.
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ABSTRACT: BACKGROUND: Symptoms of posttraumatic stress disorder (PTSD) and depression frequently co-occur, but their distinctiveness following trauma remains unclear. We examined patterns of PTSD and depression symptoms after sexual assault to evaluate the extent to which assault survivors primarily reported symptoms of both disorders or whether there were meaningfully distinct subgroups with discordant PTSD and depression symptoms. METHODS: Latent profile analysis was used to examine self-reported PTSD and depression symptoms among 119 female sexual assault survivors at 1-, 2-, 3-, and 4-months post-assault. RESULTS: At all time points, a 4-class solution fit the data best, revealing four subgroups with low, low-moderate, high-moderate, and severe levels of both PTSD and depression symptoms. Within each subgroup, PTSD symptom severity co-occurred with comparable depression symptom severity. At no time point were there reliable subgroups with discordant PTSD and depression symptom severities. Emotional numbing, hyperarousal, and overall PTSD symptom severity reliably distinguished each class from the others. Class membership at 1-month post-assault predicted subsequent class membership and functional impairment. LIMITATIONS: Additional research is needed to evaluate predictors of class membership, temporal stability of classes, and generalizability to other trauma populations. CONCLUSIONS: Co-occurring and comparably severe PTSD and depression symptoms are pervasive among female sexual assault survivors. The absence of a distinct subset of individuals with only PTSD or depression symptoms suggests that PTSD and depression may be manifestations of a general posttraumatic stress response rather than distinct disorders after trauma. Integrated treatments targeting both PTSD and depression symptoms may therefore prove more efficient and effective.Journal of affective disorders 03/2013; · 3.76 Impact Factor -
Article: Trajectories of PTSD symptoms following sexual assault: is resilience the modal outcome?
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ABSTRACT: Theoretical frameworks positing qualitatively distinct trajectories of posttrauma outcome have received initial empirical support, but have not been investigated in cases of severe interpersonal trauma. To address this limitation, we conducted latent class growth analysis with longitudinal data collected from 119 female sexual assault survivors at 1-, 2-, 3-, and 4-months postassault. Participants' mean age was 33 years; 63% were White. We hypothesized that given the severity of exposure associated with sexual assault, resilience would not be the modal course of adaptation. Four distinct PTSD growth trajectories, representing unique latent classes of participants, best fit the data: a high chronic trajectory, a moderate chronic trajectory, a moderate recovery trajectory, and a marked recovery trajectory. Contrary to previous studies and recent theoretical models, resilience and resistance trajectories were not observed, as high levels of distress were evident in nearly all participants at 1-month postassault. These results suggest that theoretical models of posttrauma response positing resilience as the modal outcome may not generalize to cases of sexual assault.Journal of Traumatic Stress 07/2012; 25(4):469-74. · 2.72 Impact Factor -
Article: A randomized placebo-controlled trial of D-cycloserine and exposure therapy for posttraumatic stress disorder.
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ABSTRACT: D-Cycloserine (DCS) is a partial NMDA receptor agonist that has been shown to enhance therapeutic response to exposure-based treatments for anxiety disorders, but has not been tested in the treatment of combat-related posttraumatic stress disorder (PTSD). The aim of this randomized, double-blind, placebo-controlled trial was to determine whether DCS augments exposure therapy for PTSD in veterans returning from Iraq and Afghanistan and to test whether a brief six-session course of exposure therapy could effectively reduce PTSD symptoms in returning veterans. In contrast to previous trials using DCS to enhance exposure therapy, results indicated that veterans in the exposure therapy plus DCS condition experienced significantly less symptom reduction than those in the exposure therapy plus placebo condition over the course of the treatment. Possible reasons for why DCS was associated with poorer outcome are discussed. Clinicaltrials.gov Registry #: NCT00371176; A Placebo-Controlled Trail of D-Cycloserine and Exposure Therapy for Combat-PTSD; www.clinicaltrials.gov/ct2/results?term=NCT00371176.Journal of psychiatric research 06/2012; 46(9):1184-90. · 3.72 Impact Factor -
Article: Training psychologists to assess, manage, and treat posttraumatic stress disorder: An examination of the National Center for PTSD Behavioral Science Division training program.
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ABSTRACT: Most traumatized people do not get the care they need, making the demand for well-trained clinicians, researchers, and supervisors in the trauma field particularly acute. We describe the psychology training program at the Behavioral Science Division of the National Center for PTSD, provide a rationale for the training procedures we employ, and summarize the challenges we face. We suggest that the trauma field needs to establish training guidelines and criterion-based outcomes, and to conduct systematic evaluation of training program efficacy. As a first step toward these goals, we present information about our program and our unique clinical and professional context to assist those who intend to develop training programs and to allow existing training programs to compare and contrast practices. (PsycINFO Database Record (c) 2012 APA, all rights reserved)Training and Education in Professional Psychology 04/2008; 2(2):67-74. · 1.58 Impact Factor
