title: A randomized controlled trial of cognitive-behavior therapy for Cambodian refugees with treatment-resistant PTSD and panic attacks: a cross-over design.
abstract: We examined the therapeutic efficacy of a culturally adapted cognitive-behavior therapy for Cambodian refugees with treatment-resistant posttraumatic stress disorder (PTSD) and comordid panic attacks. We used a cross-over design, with 20 patients in the initial treatment (IT) condition and 20 in delayed treatment (DT). Repeated measures MANOVA, Group & times; Time ANOVAs, and planned contrasts indicated significantly greater improvement in the IT condition, with large effect sizes (Cohen's d) for all outcome measures: Anxiety Sensitivity Index (d = 3.78), Clinician-Administered PTSD Scale (d = 2.17), and Symptom Checklist 90-R subscales (d = 2.77). Likewise, the severity of (culturally related) neck-focused and orthostasis-cued panic attacks, including flashbacks associated with these subtypes, improved across treatment.
authors.affiliation: Southeast Asian Clinic, Arbour Counseling Services, Lowell, Massachusetts, USA. devon_hinton@hms.harvard.edu
authors.forename: Devon E
authors.initials: DE
authors.lastname: Hinton
authors.forename: Dara
authors.initials: D
authors.lastname: Chhean
authors.forename: Vuth
authors.initials: V
authors.lastname: Pich
authors.forename: Steven A
authors.initials: SA
authors.lastname: Safren
authors.forename: Stefan G
authors.initials: SG
authors.lastname: Hofmann
authors.forename: Mark H
authors.initials: MH
authors.lastname: Pollack
mesh_terms: D002160:Cambodia / Q000208:ethnology; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003213:Conditioning, Psychological; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000523:psychology; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009333:Neck; D016584:Panic Disorder / Q000208:ethnology / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D012036:Refugees / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000208:ethnology / Q000523:psychology / Q000628:therapy*; D014481:United States