Cognitive Processing Therapy for Substance‐Involved Sexual Assault: Does an Account Help or Hinder Recovery?
Open accessAbstract
Sexual assault (SA) often occurs in the context of substances, which can impair the trauma memory and contribute to negative cognitions like self‐blame. Although these factors may affect posttraumatic stress disorder (PTSD) treatment, outcomes for substance‐involved SA have not been evaluated or compared with other types of SA. As such, we conducted a secondary analysis of a dismantling trial for cognitive processing therapy (CPT), focusing on 58 women with an index trauma of SA that occurred since age 14. Women who experienced a substance‐involved SA (n = 21) were compared with those who experienced a non–substance‐involved SA (n = 37). Participants were randomized to CPT, CPT with written account (CPT+A), or written account only (WA). Regressions controlling for pretreatment symptom levels revealed no differences by SA type in PTSD severity at posttreatment. At 6‐month follow‐up, substance‐involved SA was associated with more severe residual PTSD severity than non–substance‐involved SA, with no significant differences by treatment condition. Among participants in the substance‐involved SA group, the largest effect for reduced PTSD symptom severity from pretreatment to follow‐up emerged in the CPT condition, d = −2.02, with reductions also observed in the CPT+A, d = −0.92, and WA groups, d = −1.23. Although more research in larger samples is needed, these preliminary findings suggest that following substance‐involved SA, a cognitive treatment approach without a trauma account may facilitate lasting change in PTSD symptoms. We encourage replications to better understand the relative value of cognitive and exposure‐based treatment for PTSD following substance‐involved SAs.
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At 6-month follow-up post-treatment, both DFSA-I and DFSA-V were associated with more severe residual PTSD severity than NDFSA.
“Treatment studies similarly demonstrate that at 6-month follow-up post-treatment, both DFSA-I and DFSA-V were associated with more severe residual PTSD severity than NDFSA (Jaffe, Kaysen, Smith, Galovski, & Resick, 2021; Russell & Curran, 2002).”
From Drug-facilitated sexual assault, impaired trauma memory, and implications for mental health treatment (2022) · cites this paper as Jaffe, Kaysen, Smith, Galovski, & Resick, 2021
The Results (Differential Treatment Efficacy; page unavailable) report higher PTSD severity at six months for the substance-involved group than for the non–substance-involved group. But the Methods (Measures; page unavailable) classify assaults only by whether the participant was under the influence; the paper does not report separate six-month findings for DFSA-I and DFSA-V. (LLM, conf=0.88)
Experimental — accuracy not yet measuredJaffe et al. (2021) still found more severe residual PTSD at post-treatment follow-up for DFSA survivors receiving the cognitive-only component.
“However, they still found more severe residual PTSD at post-treatment follow-up for DFSA survivors receiving the cognitive-only component.”
From Drug-facilitated sexual assault, impaired trauma memory, and implications for mental health treatment (2022) · cites this paper as Jaffe et al., 2021
The Results (Differential Treatment Efficacy; page unavailable) report higher residual PTSD severity at six-month follow-up after substance-involved than non–substance-involved sexual assault. They do not establish that this finding was specific to survivors receiving cognitive-only CPT: the difference did not significantly vary by treatment condition. The paper also studies substance-involved assault, not a separately identified DFSA group. (LLM, conf=0.86)
Experimental — accuracy not yet measuredJaffe et al. (2021) identified better outcomes for DFSA survivors receiving cognitive processing therapy when they did not include the written account component, in order to curtail the risk of increased rumination in attempting to focus on recalling memories.
“Indeed, Jaffe et al. (2021) identified better outcomes for DFSA survivors receiving cognitive processing therapy when they did not include the written account component, in order to curtail the risk of increased rumination in attempting to focus on recalling memories.”
From Drug-facilitated sexual assault, impaired trauma memory, and implications for mental health treatment (2022) · cites this paper as Jaffe et al., 2021
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Cited by
Sorted by citations
Fields, L., Young, D. A., Patel, A. R., Munroe, C., Shumway, M., Bell, S., & Richer, L. A. (2022) · European Journal of Psychotraumatology · doi:10.1080/20008198.2022.2057165 · Cited by 22 · see citing works
- Authors
- Jaffe, A. E., Kaysen, D., Smith, B. N., Galovski, T., & Resick, P. A.
- Affiliations
- University of Nebraska–Lincoln (US)
- Stanford Medicine (US)
- Boston University (US)
- Duke University (US)
- Corresponding author
- Jaffe, Anna E.
- Venue
- Journal of Traumatic Stress
- Publisher
- Wiley
- Published
- 2021-04-05
- Volume
- 34
- Issue
- 4
- Pages
- 864-871
- ISSN
- 0894-9867 (ISSN-L)
- 1573-6598
- PMC
- PMC8507500
- OpenAlex
- W3139853079
- Cited by
- 13
- References
- 2
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 1 · 2023: 3 · 2022: 5
- FWCI
- 1.53
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Traumatic Stress (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (T32AA007455, R01AA020252)
- National Institute of Mental Health (R01MH51509)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Gender Studies › Sexual Assault and Victimization Studies
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- cognitive processing therapy, post-traumatic stress disorder, women survivors, traumatic memory, self-blame, PTSD treatment outcomes, exposure therapy
- MeSH terms
- Adolescent, Cognition, Female, Humans, Sex Offenses, Stress Disorders, Post-Traumatic, Cognitive Behavioral Therapy, Treatment Outcome
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