title: Long-term outcomes of cognitive-behavioral treatments for posttraumatic stress disorder among female rape survivors.
abstract: OBJECTIVE
  We conducted a long-term follow-up (LTFU) assessment of participants from a randomized controlled trial comparing cognitive processing therapy (CPT) with prolonged exposure (PE) for posttraumatic stress disorder (PTSD). Competing hypotheses for positive outcomes (i.e., additional therapy, medication) were examined.
  
  
  METHODS
  Intention-to-treat (ITT) participants were assessed 5-10 years after participating in the study (M = 6.15, SD = 1.22). We attempted to locate the 171 original participants, women with PTSD who had experienced at least one rape. Of 144 participants located, 87.5% were reassessed (N = 126), which constituted 73.7% of the original ITT sample. Self-reported PTSD symptoms were the primary outcome. Clinician-rated PTSD symptoms, comorbid diagnoses, and self-reported depression were secondary outcomes.
  
  
  RESULTS
  Substantial decreases in symptoms due to treatment (as reported in Resick, Nishith, Weaver, Astin, & Feuer, 2002) were maintained throughout the LTFU period, as evidenced by little change over time from posttreatment through follow-up (effect sizes ranging from pr = .03 to .14). No significant differences emerged during the LTFU between the treatment conditions (Cohen's d = 0.06-0.29). The ITT examination of diagnostics indicated that 22.2% of CPT and 17.5% of PE participants met the diagnosis for PTSD according to the Clinician-Administered PTSD Scale (Blake et al., 1995) at the LTFU. Maintenance of improvements could not be attributed to further therapy or medications.
  
  
  CONCLUSIONS
  CPT and PE resulted in lasting changes in PTSD and related symptoms over an extended period of time for female rape victims with extensive histories of trauma.
authors.affiliation: National Center for PTSD/VA Boston Healthcare System, Boston, Massachusetts 01230, USA. patricia.resick@va.gov
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Resick
authors.forename: Lauren F
authors.initials: LF
authors.lastname: Williams
authors.forename: Michael K
authors.initials: MK
authors.lastname: Suvak
authors.forename: Candice M
authors.initials: CM
authors.lastname: Monson
authors.forename: Jaimie L
authors.initials: JL
authors.lastname: Gradus
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011902:Rape / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*; D017741:Survivors / Q000523:psychology*; D016896:Treatment Outcome; D014930:Women / Q000523:psychology