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Introduction
Publications
Publications (85)
Importance:
Serotonin reuptake inhibitors (SRIs) are the only medications approved for obsessive-compulsive disorder (OCD), yet most patients taking SRIs exhibit significant symptoms. Adding exposure/response prevention (EX/RP) therapy improves symptoms, but it is unknown whether patients maintain wellness after discontinuing SRIs.
Objective:
To...
Practice guidelines for adults with obsessive-compulsive disorder (OCD) recommend augmenting serotonin reuptake inhibitors (SRIs) with exposure and ritual prevention (EX/RP). However, fewer than half of patients remit after a standard 17-session EX/RP course. We studied whether extending the course increased overall remission rates and which patien...
Estimates of the rate of sexual victimization in college men vary wildly - likely due to the lack of validated measures. This study provides psychometric data on the Sexual Experiences Survey - Short Form Victimization (SES-SFV) and basic descriptive characteristics of sexual victimization of college men via the SES-SFV. Participants (n = 405) comp...
Research has revealed that forms of violence are interconnected, but less work focuses on the interconnection of victimization and perpetration, particularly with men. Subsequently, our understanding of the complexities of violence exposure in men’s lives and related policies and treatments remains limited. The present study utilizes a sample of at...
Objective: Sexual victimization affects at least one in five college women and up to one in six college men; however, the exact rates of sexual perpetration are difficult to ascertain because of inconsistencies in the measurement of these behaviors. The present study is the first to evaluate the extent to which three commonly used measures of sexua...
Introduction: Estimates of sexual perpetration in college men vary widely, partially due to a lack of reliable and valid measures of sexual perpetration. This study provides psychometric data on the Sexual Experiences Survey – Short Form Perpetration (SES-SFP), a revision of one of the most widely used measures of sexual perpetration, in a sample o...
The current study examined how psychological factors influence hypothetical behavioral responses to threat (BRTT). College women (n = 113) with a history of sexual victimization completed a standardized lab-based self-defense scenario. Interpersonal skills, coping style, and assertive and non-assertive BRTT during a prior assault predicted assertiv...
Sexual minority men are at increased risk for sexual victimization at all ages compared to heterosexual men; yet, most research on victimization focuses on the experiences of heterosexual women. This study compares the rates of multiple forms of interpersonal violence (violence perpetrated by another person) in a sample of sexual minority status co...
The current study examined how psychological factors influence hypothetical behavioral responses to threat (BRTT). College women ( n = 113) with a history of sexual victimization completed a standardized lab-based self-defense scenario. Interpersonal skills, coping style, and assertive and nonassertive BRTT during a prior assault predicted assertiv...
Objective: During a potential sexual assault experience, an active, assertive behavioral response to threat (BRTT) can be protective while a non-assertive BRTT may increase risk. However, little is known about how the sequence of behaviors that a woman engages in during a threatening situation may be related to sexual victimization. The present stu...
Despite extensive research on sexual assault, study of the processes and behaviors central to responding to sexual assault threats is limited. The purpose of this paper is to provide a critical, narrative review of the literature on behavioral response to threat (BRTT) highlighting BRTT BR TT as mechanism of self-defense interventions and process o...
This study evaluated 146 college women’s responses to date rape risk in order to test an experimental paradigm for studying threat response. Participants were randomized to four conditions; in three conditions, the level of threat participants were initially exposed to was controlled experimentally, in the control condition, participants self selec...
Objective: One in four college women experience sexual assault on campus. Campuses rarely provide the in depth self-defense programs needed to reduce sexual assault risk. Not much is known about the range of possible behaviors elicited by sexual assault threat stimuli besides assertion. To fill this gap, the aim of the current study was to explore...
Objective: Sexual victimization affects at least 1 in 5 college women and up to 1 in 6 college men; however, the exact rates of sexual perpetration are difficult to ascertain because of inconsistencies in the measurement of these behaviors. The present study is the first to evaluate the extent to which 3 commonly used measures of sexual violence (S...
Objective: During a potential sexual assault experience, an active, assertive behavioral response to threat (BRTT) can be protective, whereas a nonassertive BRTT may increase risk. However, little is known about how the sequence of behaviors that a woman engages in during a threatening situation may be related to sexual victimization. The present s...
(Reprinted with permission from Depression and Anxiety 2014; 31:412-419).
This study provides psychometric data on the Sexual Experiences Survey—Short Form Perpetration (SES-SFP), a revision of one of the most widely used measures of sexual perpetration, in a sample of college men. Participants (n = 402) completed a web survey containing the study measures; a subset of 66 participants completed the SES-SFP again 2 weeks...
Research has revealed that forms of violence are interconnected, but less work focuses on the interconnection of victimization and perpetration, particularly with men. Subsequently, our understanding of the complexities of violence exposure in men’s lives and related policies and treatments remains limited. The present study utilizes a sample of at...
Sexual minority men are at increased risk for sexual victimization at all ages compared to heterosexual men; yet, most research on victimization focuses on the experiences of heterosexual women. This study compares the rates of multiple forms of interpersonal violence (violence perpetrated by another person) in a sample of sexual minority status co...
Estimates of the rate of sexual victimization in college men vary wildly, likely because of the lack of validated measures. This study provides psychometric data on the Sexual Experiences Survey?Short Form Victimization (SES-SFV) and basic descriptive characteristics of sexual victimization of college men via the SES-SFV. Participants (n = 405) com...
One in four college women experience sexual assault on campus; yet, campuses rarely provide the in-depth self-defense programs needed to reduce sexual assault risk. Further, little is known about the range of possible behaviors elicited by sexual assault threat stimuli besides assertion. To fill this gap, the aim of the current study was to explore...
We examined outcomes from a residential treatment program emphasizing exposure and response prevention (ERP) to determine if the typically robust response to this treatment in outpatient settings extends to patients treated in this unique context.
One hundred and seventy-two adolescents with primary Obsessive-compulsive disorder (OCD) completed mea...
In spite of an elevated prevalence of trauma histories among prisoners, there has been little research examining the relationship between incarceration and posttraumatic stress disorder (PTSD); this is especially true for Black Americans.
To examine relationships between PTSD and incarceration in a nationally representative sample of Black American...
Objective:
To compare outcomes after 6-month maintenance treatment of adults diagnosed with obsessive-compulsive disorder (OCD) based on DSM-IV criteria who responded to acute treatment with serotonin reuptake inhibitors (SRIs) augmented by exposure and response prevention (EX/RP) or risperidone.
Method:
A randomized trial was conducted at 2 aca...
Previous research has illuminated the relationship between childhood victimization and later adulthood revictimization. However, researchers have investigated this relationship primarily with women’s experience of sexual assault. Thus, data on men’s experiences of childhood victimization and adolescent/adulthood revictimization is limited. Moreover...
Background
Prolonged Exposure (PE) therapy is an efficacious treatment for PTSD; despite this, many clinicians do not utilize it due to concerns it could cause patient decompensation. Method
Data were pooled from four published well-controlled studies of female assault survivors with chronic PTSD (n = 361) who were randomly assigned to PE, waitlist...
This study evaluates the novel use of the response-latency paradigm to elicit women's hypothetical behavioral responses to the threat of acquaintance rape. There were 146 college women recruited and randomly assigned to 4 study conditions. In 3 of the conditions, the threat to which participants responded was experimentally controlled; in the fourt...
Although research concerning the effects of traumatic and stressful life events on an individual's mental health has been plentiful in the past several decades, research aimed at understanding the nature of resilience and its role in this process has been less plentiful. The present study examined the relationship between a commonly used measure of...
Importance:
Obsessive-compulsive disorder (OCD) is one of the world's most disabling illnesses according to the World Health Organization. Serotonin reuptake inhibitors (SRIs) are the only medications approved by the Food and Drug Administration to treat OCD, but few patients achieve minimal symptoms from an SRI alone. In such cases, practice guid...
This article describes the long-term effects of augmenting serotonin reuptake inhibitors (SRIs) with exposure and ritual prevention or stress management training in patients with DSM-IV obsessive-compulsive disorder (OCD).
Between November 2000 and November 2006, 111 OCD patients from 2 academic outpatient centers with partial SRI response were ran...
Purpose:
Eating disorders and obsessive-compulsive disorder (OCD) commonly co-occur, but there is little data for how to treat these complex cases. To address this gap, we examined the naturalistic outcome of 56 patients with both disorders, who received a multimodal treatment program designed to address both problems simultaneously.
Methods:
A...
To examine the efficacy and durability of a behavioral therapy (BT) protocol for pediatric TTM compared with a minimal attention control (MAC) condition. It was hypothesized that the BT condition would be superior to MAC at the end of acute treatment, and would also demonstrate durability of gains through the maintenance treatment phase.
A randomiz...
The present study sought to replicate and extend a study by Abramowitz et al. (2009), who examined how well experiential avoidance (EA) and obsessive beliefs predicted obsessive-compulsive (OC) symptoms in a non-clinical sample. The current study utilized a severe, clinical, treatment-seeking sample (N=108), and examined how well EA and obsessive b...
Memory consolidation is enhanced by emotional arousal, an effect mediated by noradrenergic beta-receptor signaling. Norepinephrine strengthens consolidation of both appetitive and aversive learning, and is implicated in extinction of conditioned responses. In this review, we summarize work on the noradrenergic mechanisms of extinction learning and...
In the current article, we address the existing assumption in the literature on cognitive behavioral treatment of PTSD that patients with severe negative trauma-related cognitions would benefit more from a treatment package that includes exposure and cognitive techniques compared with a treatment that includes exposure only. To test this assumption...
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]. Metho...
This chapter reviews the extant literature on cognitive-behavioral therapy (CBT) for chronic (duration of symptoms greater than 3 months) posttraumatic stress disorder (PTSD) among adults. Due to the strength of the literature base in this area, only published or "in press" empirical studies are included and only some studies are highlighted in the...
Posttraumatic 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 Psychological Association] Kimerling et al. [2000: Trauma and Health: J Trauma Stress 13:115-128].
These analyses e...
Although serotonin reuptake inhibitors (SRIs) are approved for the treatment of obsessive-compulsive disorder (OCD), most OCD patients who have received an adequate SRI trial continue to have clinically significant OCD symptoms. The purpose of this study was to examine the effects of augmenting SRIs with exposure and ritual prevention, an establish...
Among trauma-exposed individuals, severity of posttraumatic stress disorder (PTSD) symptoms is strongly correlated with anger. The authors used 2 longitudinal data sets with 282 and 218 crime victims, respectively, to investigate the temporal sequence of anger and PTSD symptoms following the assault. Cross-lagged regression analyses indicated that...
Exposure therapy is an effective primary intervention for the treatment of specific phobias, obsessive-compulsive disorder (OCD), posttraumatic stress disorder, and acute stress disorder. The efficacy of cognitive-behavior programs in which exposure is a major component for the treatment of panic disorder (PD), social anxiety disorder (SAD), and ge...
IntroductionHistorical survey of the development of exposure therapy and evidence for its efficacyVirtual realitySummary
Boyer & Lienard's (B&L's) model of obsessive-compulsive disorder (OCD) rituals does not completely conform to our clinical experience with patients, and the clinical implications of their model is not described by the authors. We discuss potential differences of opinion regarding both the nature of OCD and the mechanisms involved in the maintenance...
Debate about psychotherapy research methods in the last decade has helped to highlight important issues related to the clinical utility of randomized controlled trials. Out of this debate, significant recent advances have been made in using randomized designs to examine treatment efficacy in settings more akin to those in the “real world” where mos...
The present study was designed to determine whether augmenting sertraline with prolonged exposure (PE) would result in greater improvement than continuation with sertraline alone. Outpatient men and women with chronic PTSD completed 10 weeks of open label sertraline and then were randomly assigned to five additional weeks of sertraline alone (n = 3...
Since the introduction of posttraumatic stress disorder (PTSD) into the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III; American Psychiatric Association, 1980), considerable research has demonstrated the efficacy of several cognitive-behavioral therapy (CBT) programs in the treatment of chronic PTSD. Among these effic...
Unlabelled:
Whereas trauma-associated arousal has been linked fairly consistently with elevations in both glucocorticoids and catecholamines, neuroendocrine correlates of hyperarousal in the context of posttraumatic stress disorder (PTSD) have been more variable. Further, neuroendocrine predictors of the development of PTSD following trauma have b...
One hundred and twenty college students (97 women) completed measures of anticipated performance for a fear-based snake behavioral avoidance task (BAT) and a skill-based basket-shooting task. Half of the participants were instructed to identify the task steps they believed themselves able to do (standard self-efficacy instructions). The remaining p...
Among the consequences of the horrific events of September 11, 2001, are increased awareness of and interest in the psychological effects of trauma and their treatment. In this chapter, we provide an overview of the psychosocial treatments for chronic posttraumatic stress disorder (PTSD) and interventions designed to prevent the development of the...
The catastrophic events of September 11, 2001, significantly raised this country's interest in and concern about the psychological consequences of mass trauma and for good reason. Epidemiological studies conducted 1 to 2 months after 9/11 reported prevalence rates of posttraumatic stress disorder (PTSD) in Lower Manhattan of between 7–11% (Galea et...
Female assault survivors (N=171) with chronic posttraumatic stress disorder (PTSD) were randomly assigned to prolonged exposure (PE) alone, PE plus cognitive restructuring (PE/CR), or wait-list (WL). Treatment, which consisted of 9-12 sessions, was conducted at an academic treatment center or at a community clinic for rape survivors. Evaluations we...
The terrorist attacks of September 11, 2001, and the constant threat of imminent terrorist activity have brought into the forefront the urgent need to prepare for the consequences of such attacks. Such preparation entails utilization of existing knowledge, identification of crucial gaps in our scientific knowledge, and taking steps to acquire this...
Posttraumatic stress disorder is a common and often chronic and disabling anxiety disorder that can develop after exposure to highly stressful events characterized by actual or threatened harm to the self or others. This is the second of two invited articles summarizing the nature and treatment of PTSD and the associated condition of acute stress d...
POST-TRAUMATIC STRESS DISORDER (PTSD) is a common and often chronic and disabling anxiety disorder that can develop after exposure to highly stressful events characterized by actual or threatened harm to the self or others. This is the first of two articles summarizing the nature and treatment of PTSD and the associated condition of acute stress di...
Effective cognitive-behavioral therapy (CBT) programs have been developed for all of the anxiety disorders. Common elements of CBT for these disorders include exposure to feared objects, situations, activities, thoughts, memories, and sensations; cognitive restructuring of dysfunctional beliefs; and training in anxiety management skills, such as co...
M. Cloitre, K. Koenen, L. R. Cohen, and H. Han (2002; see record 2002-18226-001) presented results of a randomized trial that clearly demonstrate the safety and efficacy of a treatment program delivering skills training in affective and interpersonal regulation (STAIR) prior to conducting imaginal exposure (IE) to trauma memories for adults with po...
This study examined the impact of comorbid personality disorders on the outcome of cognitive behavioral treatment for women with chronic posttraumatic stress disorder (PTSD). Seventy-five adult women with PTSD resulting from rape or nonsexual assault in adulthood or sexual abuse in childhood were treated with prolonged exposure with or without cogn...
Treatment manuals have proven extremely useful in implementing exposure and ritual prevention (EX/RP) with patients with obsessive-compulsive disorder (OCD). Nevertheless, treatment manuals cannot possibly attend to all possible situations encountered in therapy, especially with OCD patients who have such a diverse range of presentations. In this a...
What treatments are effective for chronic posttraumatic stress disorder (PTSD) and the prevention of PTSD following trauma? The current review illustrates the basic effi- cacy of several psychosocial treatments for PTSD (ie, exposure, stress inoculation train- ing, eye movement desensitization and reprocessing, cognitive therapy); discusses com- pa...
We investigated three questions related to anger and the treatment of chronic posttraumatic stress disorder (PTSD), utilizing data from a previously published study of cognitive behavioral therapies (CBTs) with female assault victims (Foa, Dancu, Hembree, Jaycox, Meadows, & Street, 1999). The questions were: (1) Do CBTs targeted at PTSD result in a...
The present investigation reports on the development and psychometric evaluation of the Penn Inventory of Scrupulosity (PIOS), a 19-item self-report scale measuring religious obsessive-compulsive symptoms. Factor analysis yielded a two factor solution with the first subscale measuring fears about having committed sin, and the second measuring fears...
Maladaptive patterns of social functioning have been widely noted as core features associated with the clinical syndrome of combat-related posttraumatic stress disorder (PTSD), including interpersonal violence, social anxiety and avoidance, marital/family discord, and occupational impairment. Unfortunately, clinical instruments for evaluating the c...
Psychometric studies have consistently shown that combat veterans evaluated for posttraumatic stress disorder (PTSD) appear to overreport psychopathology as exhibited by (a) extreme and diffuse levels of psychopathology across instruments measuring different domains of mental illness, and (b) extreme elevations on the validity scales of the MMPI-MM...
Eye movement desensitization and reprocessing (EMDR) (Shapiro, 1995, 1989), a relatively new form of psychotherapy, is controversial. I will focus on two aspects of this controversy. The first involves various claims that, compared to other forms of cognitive-behavioral therapy (CBT) that have received empirical support as treatments for posttrauma...
In the past 10 years, there has been increased recognition of the magnitude of the problems of sexual assault-related violence, domestic violence, and marital rape. It has been shown across a range of studies that completed rape is a potentially traumatic event that is associated with the greatest risk of posttraumatic stress disorder (PTSD) among...
Research on Eye Movement Desensitization and Reprocessing therapy (EMDR) was reviewed to answer the questions “Does EMDR work?” and “If so, Why?” This first question was further subdivided on the basis of the control group: (a) no-treatment (or wait list control), (b) nonvalidated treatments, and (c) other validated treatments. The evidence support...
Research on Eye Movement Desensitization and Reprocessing therapy (EMDR) was reviewed to answer the questions “Does EMDR work?” and “If so, Why?” This first question was further subdivided on the basis of the control group: (a) no-treatment (or wait list control), (b) nonvalidated treatments, and (c) other validated treatments. The evidence support...
Pitman et al. recently published a pair of studies on the relationship between indicators of emotional processing and outcome in flooding therapy (Compr Psychiatry 1996;37:409-416) and eye movement desensitization and reprocessing therapy (EMDR; Compr Psychiatry 1996;37:419-429). Among their conclusions, they asserted EMDR was found to be at least...
