Residual Symptoms Following Empirically Supported Treatment for PTSD

Objective: Although there are several evidence-based treatments that are effective in mitigating the symptoms of posttraumatic stress disorder (PTSD), rates of nonresponse to treatment as well as treatment dropout remain high. In order to determine which symptoms remain most problematic at the end of treatment for PTSD, the present study examined residual symptoms in a treatment study that evaluated the effects of cognitive processing therapy (CPT) and prolonged exposure (PE). Method: The sample consisted of 108 female rape survivors who initially met criteria for PTSD and who were then randomized into and completed either CPT or PE. The sample was 71% White and 25% African American, with an average age of 32 years (SD = 9.98 years). Results: Symptoms of PTSD, depression, guilt, and social adjustment were evaluated in the sample of treatment completers, and findings suggest that overall symptoms improved over the course of treatment. Results further suggested that distress related to trauma reminders, detachment, and insomnia were the most common residual PTSD symptoms at posttreatment, while self-blame, concerns about body image, and fatigue were the most common residual symptoms of depression. The most common residual symptom of guilt was lack of justification for actions that had to be taken during the index event. Conclusions: This pattern of findings is in line with past research suggesting that evidence-based practices are effective in the treatment of PTSD, but underscores the need to continue to evaluate residual symptoms to best assist clients in achieving full recovery.