Trauma and Women: Course, Predictors, and Treatment

Posttraumatic stress disorder (PTSD) resulting from aggravated assault, rape, or noncrime traumaaffects over 4 million women in the United States, according to retrospective studies. Prospectivestudies reviewed here found that 3 months post assault the prevalence of PTSD was 48% in rape victimsand 25% in nonsexual crime victims. Prolonged exposure treatment and stress inoculation trainingare both effective psychotherapeutic treatments for PTSD. Prolonged exposure involves havingthe patient relive the traumatic memory and recount the event in detail. This description is audiotapedand the patient is asked to listen to it as part of assigned homework. In vivo exposure to feared objectsor situations is also assigned as homework. Stress inoculation training consists of teaching patients avariety of techniques for managing anxiety, including controlled breathing, deep muscle relaxation,thought-stopping, cognitive restructuring, preparation for stressors, covert modeling, and role-play.Both treatments have been proven to be effective alone and in combination in ameliorating chronicPTSD in women after traumatic sexual or nonsexual assault. This efficacy was maintained for 3months of follow-up.