Violent crimes represent a societal problem, and victims, namely women, often develop posttraumatic stress disorder (PTSD). Previous studies have identified acute stress disorder (ASD) as a predictor of PTSD, as well as dissociation. However, there are some inconsistencies regarding which cluster or symptom has better predictive power, and the impact of gender is still unknown in victims of violent crimes. The aim of this study was to determine the predictive power of full and partial ASD diagnosis, clusters, and symptoms according to gender. To do so, 39 women and 36 men were evaluated using validated semi-structured clinical interviews within 30 days post crime for ASD and 2 months later for PTSD. Results showed that 52% of individuals had full ASD and 20% has partial ASD, 40% had full PTSD and 17% had partial PTSD. Both full and partial ASD diagnoses, as well as all clusters, and most symptoms, were good predictors of PTSD. No gender differences were observed concerning the predictive power of ASD clusters and symptoms. The decreased emphasis on dissociative reactions in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5) to establish an ASD diagnosis appears relevant to better identify women and men at risk of PTSD after a violent crime, and to deliver appropriate early preventive interventions.
Part of the book: A Multidimensional Approach to Post-Traumatic Stress Disorder
In cases of post-traumatic stress disorder (PTSD), nightmares can often persist, even after a cognitive behavioral therapy (CBT) for this disorder. Imagery rehearsal therapy (IRT) is a CBT that targets the treatment of nightmares directly. Objectives: the present study describes the feasibility and the efficacy of combining IRT with first-line, trauma-focused CBT for PTSD. Method: two individuals with PTSD took part in this experimental case study protocol. The efficacy of the combined treatment was evaluated using semi-structured interviews, self-report questionnaires, and daily self-monitoring diaries. Results: after three IRT sessions for Participant 1 and five IRT sessions for Participant 2, combined with CBT for PTSD, both participants experienced a slight decrease in sleep difficulties and in the intensity of their PTSD symptoms post-treatment. More particularly, one participant demonstrated a significant decrease in the level of distress associated with his post-traumatic nightmares (PTNM). Conclusions: these results demonstrate that it is possible and promising to combine IRT with CBT for PTSD.
Part of the book: Cognitive Behavioral Therapy and Clinical Applications