Analyzing individual patterns of change in two treatments for posttraumatic stress disorder
Selvig, Amy Lynne
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Two therapies for posttraumatic stress disorder (PTSD) have received considerable support in the clinical literature: prolonged imaginal exposure (PE) and eye movement desensitization and reprocessing (EMDR). Although PE is empirically supported, its critics purport that it causes symptom exacerbation. In contrast, proponents of EMDR claim that its response pattern is characterized by rapid decline in symptoms. The current investigation aimed to study and compare the patterns of symptom change during PE and EMDR using hierarchical linear modeling (HLM). HLM avoids many shortcomings inherent in traditional longitudinal analyses by focusing on trajectories of change rather than group means. 62 women with PTSD following rape were randomly assigned to 9 sessions of PE or EMDR. Results indicated that neither group experienced symptom exacerbation nor rapid symptom decline. The patterns of symptom change in the two groups were not significantly different. The strengths and limitations of HLM and the study’s design were discussed.