title: Differential effect of exposure-based therapy and cognitive therapy on post-traumatic stress disorder symptom clusters: A randomized controlled trial.
abstract: A question remains regarding differential effects of exposure-based versus non-exposure-based therapies on specific post-traumatic stress disorder (PTSD) symptom clusters. Traumatized emergency room patients were randomized to receive prolonged exposure (PE) or cognitive therapy (CT) without exposure. PE/CT had no differential effect on individual symptom clusters, and change in total PTSD score remained significant even after controlling for the reductions in all three symptom clusters. In addition, baseline levels of PTSD avoidance/intrusion/hyperarousal did not moderate the effects of PE and CT on total PTSD symptom scores. Taken together, these findings challenge the notion that PE and CT are specifically, and differentially, useful in treating one particular PTSD symptom cluster.
  
  
  
  Despite their different theoretical backgrounds and techniques, the notion that PE and CT (without exposure) target different PTSD symptoms was not confirmed in this study. Thus, both interventions may in fact be equally effective for treating intrusion, avoidance and hyperarousal symptoms. Baseline levels of avoidance, intrusion and hyperarousal may not be good a priori indicators for PTSD treatment selection. The effect of PE and CT on PTSD as a whole does not seem to depend on a reduction in any specific symptom cluster. These findings indicate that exposure and non-exposure interventions may lead to similar results in terms of reductions in specific PTSD symptoms. It is quite possible that individual PTSD clusters may respond to therapy in an inter-related fashion, with one cluster affecting the other.
authors: Department of Psychology, Bar-Ilan University, Ramat Gan, Israel.|Department of Psychiatry, New York University School of Medicine, USA.
authors: Danny
authors: D
authors: Horesh
authors: Department of Psychiatry, New York University School of Medicine, USA.
authors: Meng
authors: M
authors: Qian
authors: Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan, Israel.
authors: Sara
authors: S
authors: Freedman
authors: Department of Psychiatry, New York University School of Medicine, USA.
authors: Arieh
authors: A
authors: Shalev
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology* / Q000628:therapy*; D055815:Young Adult
keywords: 
  PTSD
  ; cognitive therapy; prolonged exposure; randomized controlled trial