title: Influence of Sleep Disturbance on Global Functioning After Posttraumatic Stress Disorder Treatment.
abstract: Chronic insomnia and recurrent nightmares are prominent features of posttraumatic stress disorder (PTSD). Evidence from adult research indicates that these sleep disturbances do not respond as well to cognitive-behavioral therapies for PTSD and are associated with poorer functional outcomes. This study examined the effect of prolonged exposure therapy for adolescents versus client-centered therapy on posttraumatic sleep disturbance, and the extent to which sleep symptoms impacted global functioning among adolescents with sexual abuse-related PTSD. Participants included 61 adolescent girls seeking treatment at a rape crisis center. The Child PTSD Symptom Scale-Interview (Foa, Johnson, Feeny, & Treadwell, 2001) was used to assess PTSD diagnosis and severity of symptoms, including insomnia and nightmares. The Children's Global Assessment Scale (Shaffer et al., 1983) was used to assess global functioning. There were significant main effects of time and treatment on insomnia symptoms. Additionally, there was a main effect of time on nightmares. Results also showed that insomnia and nightmares significantly predicted poorer global functioning posttreatment (R2= .21). Despite significant improvements in posttraumatic sleep disturbance, there were still clinically significant insomnia symptoms after treatment, suggesting that additional interventions may be warranted to address residual sleep disturbance in PTSD.
authors.affiliation: Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Janeese A
authors.initials: JA
authors.lastname: Brownlow
authors.affiliation: Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Carmen P
authors.initials: CP
authors.lastname: McLean
authors.affiliation: Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Gehrman
authors.affiliation: Behavioral Health Service/Research, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA.
authors.forename: Gerlinde C
authors.initials: GC
authors.lastname: Harb
authors.affiliation: Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.|Behavioral Health Service/Research, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Ross
authors.affiliation: Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Edna B
authors.initials: EB
authors.lastname: Foa
mesh_terms: D000293:Adolescent; D004325:Dreams / Q000523:psychology; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000706:statistics & numerical data*; D016014:Linear Models; D009629:Person-Centered Psychotherapy / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D012742:Sex Offenses / Q000523:psychology*; D012893:Sleep Wake Disorders / Q000523:psychology / Q000628:therapy*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*; D013997:Time Factors