Efficacy of specialized group psychotherapy for survivors of childhood sexual abuse in reducing symptoms of PTSD and general psychiatric distress: 5 year follow-up of a randomized trial

Henriette Kiilsholm Elkjær; Ellids Kristensen; Erik Lykke Mortensen; Stig Bernt Poulsen; Marianne Engelbrecht Lau

Efficacy of specialized group psychotherapy for survivors of childhood sexual abuse in reducing symptoms of PTSD and general psychiatric distress: 5 year follow-up of a randomized trial

Henriette Kiilsholm Elkjær, Ellids Kristensen, Erik Lykke Mortensen, Stig Bernt Poulsen, Marianne Engelbrecht Lau

Abstract

Background and purpose: Several studies have found that women who have experienced
childhood sexual abuse (CSA) have an increased risk of developing Post-Traumatic Stress
Disorder (PTSD) related to their victimization experiences. The current study evaluated the
presence of PTSD symptoms and general psychiatric distress (GSI from SCL-90-R) five years
after discharge among adult women suffering from sequelae from childhood sexual abuse.
Materials and method: This 5-year follow-up study of a randomized controlled trial included
106 women: 52 assigned to analytic group psychotherapy and 54 assigned to systemic group
psychotherapy. PTSD symptoms and general psychiatric distress were evaluated at baseline,
at discharge, 1 year and 5 years after discharge, using the crime-related post-traumatic stress
disorder scale (CR-PTSD) and the Global Severity Index (GSI) from the Symptom Checklist-
90-Revised (SCL-90-R). At the 5 year follow-up, the PTSD Checklist-Civilian (PCL-C) was also
administered to confirm the findings from CR-PTSD and to determine whether the women met
the DSM-IV symptom criteria of PTSD. ANOVA was performed using treatment group as a
between factor and the four time points as repeated measures.
Results: PTSD symptoms and general psychiatric distress were significantly reduced during
therapy for both treatment modalities (P < 0.000), but the systemic group exhibited significantly
more reduction of PTSD symptoms than the analytic group (P < 0.002) at discharge. No
difference in reduction of PTSD symptoms and general psychiatric distress was found
between groups at 1 and 5 year follow-up. Difference in trajectories was found for the two
groups (time*treatment group interaction, CR-PTSD, P = 0.012 and GSI, P = 0.021). Level of
PTSD symptoms on the CR-PTSD was validated at 5 year follow-up by the total symptom
severity score on the PCL-C (r = 0.929). Of the women participating in the 5-years follow-up,
18 (28%) met the DSM-IV symptom criteria as measured by PCL-C (analytic: 36%, systemic:
21%, χ2 NS).
Conclusion: Symptoms of PTSD and general psychiatric distress were reduced in women
with a history of CSA participating in both analytic and systemic specialized incest group
psychotherapy. Improvement was maintained for both groups at 5-year-follow-up. The
trajectories of PTSD symptoms and GSI for the two groups differed significantly, however.
Implications of the difference in trajectories for treatment planning will be discussed. The
findings in the present study stress the importance of long-term follow-up studies in evidencebased reserch.

Original language	English
Publication date	2012
Publication status	Published - 2012

Cite this

@conference{48b58a96f590482f87abebc45ee465a4,

title = "Efficacy of specialized group psychotherapy for survivors of childhood sexual abuse in reducing symptoms of PTSD and general psychiatric distress: 5 year follow-up of a randomized trial",

abstract = "Background and purpose: Several studies have found that women who have experienced childhood sexual abuse (CSA) have an increased risk of developing Post-Traumatic Stress Disorder (PTSD) related to their victimization experiences. The current study evaluated the presence of PTSD symptoms and general psychiatric distress (GSI from SCL-90-R) five years after discharge among adult women suffering from sequelae from childhood sexual abuse. Materials and method: This 5-year follow-up study of a randomized controlled trial included 106 women: 52 assigned to analytic group psychotherapy and 54 assigned to systemic group psychotherapy. PTSD symptoms and general psychiatric distress were evaluated at baseline, at discharge, 1 year and 5 years after discharge, using the crime-related post-traumatic stress disorder scale (CR-PTSD) and the Global Severity Index (GSI) from the Symptom Checklist- 90-Revised (SCL-90-R). At the 5 year follow-up, the PTSD Checklist-Civilian (PCL-C) was also administered to confirm the findings from CR-PTSD and to determine whether the women met the DSM-IV symptom criteria of PTSD. ANOVA was performed using treatment group as a between factor and the four time points as repeated measures. Results: PTSD symptoms and general psychiatric distress were significantly reduced during therapy for both treatment modalities (P < 0.000), but the systemic group exhibited significantly more reduction of PTSD symptoms than the analytic group (P < 0.002) at discharge. No difference in reduction of PTSD symptoms and general psychiatric distress was found between groups at 1 and 5 year follow-up. Difference in trajectories was found for the two groups (time*treatment group interaction, CR-PTSD, P = 0.012 and GSI, P = 0.021). Level of PTSD symptoms on the CR-PTSD was validated at 5 year follow-up by the total symptom severity score on the PCL-C (r = 0.929). Of the women participating in the 5-years follow-up, 18 (28%) met the DSM-IV symptom criteria as measured by PCL-C (analytic: 36%, systemic: 21%, χ2 NS). Conclusion: Symptoms of PTSD and general psychiatric distress were reduced in women with a history of CSA participating in both analytic and systemic specialized incest group psychotherapy. Improvement was maintained for both groups at 5-year-follow-up. The trajectories of PTSD symptoms and GSI for the two groups differed significantly, however. Implications of the difference in trajectories for treatment planning will be discussed. The findings in the present study stress the importance of long-term follow-up studies in evidencebased reserch.",

author = "Elkj{\ae}r, {Henriette Kiilsholm} and Ellids Kristensen and Mortensen, {Erik Lykke} and Poulsen, {Stig Bernt} and Lau, {Marianne Engelbrecht}",

year = "2012",

language = "English",

}

TY - CONF

T1 - Efficacy of specialized group psychotherapy for survivors of childhood sexual abuse in reducing symptoms of PTSD and general psychiatric distress

T2 - 5 year follow-up of a randomized trial

AU - Elkjær, Henriette Kiilsholm

AU - Kristensen, Ellids

AU - Mortensen, Erik Lykke

AU - Poulsen, Stig Bernt

AU - Lau, Marianne Engelbrecht

PY - 2012

Y1 - 2012

N2 - Background and purpose: Several studies have found that women who have experienced childhood sexual abuse (CSA) have an increased risk of developing Post-Traumatic Stress Disorder (PTSD) related to their victimization experiences. The current study evaluated the presence of PTSD symptoms and general psychiatric distress (GSI from SCL-90-R) five years after discharge among adult women suffering from sequelae from childhood sexual abuse. Materials and method: This 5-year follow-up study of a randomized controlled trial included 106 women: 52 assigned to analytic group psychotherapy and 54 assigned to systemic group psychotherapy. PTSD symptoms and general psychiatric distress were evaluated at baseline, at discharge, 1 year and 5 years after discharge, using the crime-related post-traumatic stress disorder scale (CR-PTSD) and the Global Severity Index (GSI) from the Symptom Checklist- 90-Revised (SCL-90-R). At the 5 year follow-up, the PTSD Checklist-Civilian (PCL-C) was also administered to confirm the findings from CR-PTSD and to determine whether the women met the DSM-IV symptom criteria of PTSD. ANOVA was performed using treatment group as a between factor and the four time points as repeated measures. Results: PTSD symptoms and general psychiatric distress were significantly reduced during therapy for both treatment modalities (P < 0.000), but the systemic group exhibited significantly more reduction of PTSD symptoms than the analytic group (P < 0.002) at discharge. No difference in reduction of PTSD symptoms and general psychiatric distress was found between groups at 1 and 5 year follow-up. Difference in trajectories was found for the two groups (time*treatment group interaction, CR-PTSD, P = 0.012 and GSI, P = 0.021). Level of PTSD symptoms on the CR-PTSD was validated at 5 year follow-up by the total symptom severity score on the PCL-C (r = 0.929). Of the women participating in the 5-years follow-up, 18 (28%) met the DSM-IV symptom criteria as measured by PCL-C (analytic: 36%, systemic: 21%, χ2 NS). Conclusion: Symptoms of PTSD and general psychiatric distress were reduced in women with a history of CSA participating in both analytic and systemic specialized incest group psychotherapy. Improvement was maintained for both groups at 5-year-follow-up. The trajectories of PTSD symptoms and GSI for the two groups differed significantly, however. Implications of the difference in trajectories for treatment planning will be discussed. The findings in the present study stress the importance of long-term follow-up studies in evidencebased reserch.

AB - Background and purpose: Several studies have found that women who have experienced childhood sexual abuse (CSA) have an increased risk of developing Post-Traumatic Stress Disorder (PTSD) related to their victimization experiences. The current study evaluated the presence of PTSD symptoms and general psychiatric distress (GSI from SCL-90-R) five years after discharge among adult women suffering from sequelae from childhood sexual abuse. Materials and method: This 5-year follow-up study of a randomized controlled trial included 106 women: 52 assigned to analytic group psychotherapy and 54 assigned to systemic group psychotherapy. PTSD symptoms and general psychiatric distress were evaluated at baseline, at discharge, 1 year and 5 years after discharge, using the crime-related post-traumatic stress disorder scale (CR-PTSD) and the Global Severity Index (GSI) from the Symptom Checklist- 90-Revised (SCL-90-R). At the 5 year follow-up, the PTSD Checklist-Civilian (PCL-C) was also administered to confirm the findings from CR-PTSD and to determine whether the women met the DSM-IV symptom criteria of PTSD. ANOVA was performed using treatment group as a between factor and the four time points as repeated measures. Results: PTSD symptoms and general psychiatric distress were significantly reduced during therapy for both treatment modalities (P < 0.000), but the systemic group exhibited significantly more reduction of PTSD symptoms than the analytic group (P < 0.002) at discharge. No difference in reduction of PTSD symptoms and general psychiatric distress was found between groups at 1 and 5 year follow-up. Difference in trajectories was found for the two groups (time*treatment group interaction, CR-PTSD, P = 0.012 and GSI, P = 0.021). Level of PTSD symptoms on the CR-PTSD was validated at 5 year follow-up by the total symptom severity score on the PCL-C (r = 0.929). Of the women participating in the 5-years follow-up, 18 (28%) met the DSM-IV symptom criteria as measured by PCL-C (analytic: 36%, systemic: 21%, χ2 NS). Conclusion: Symptoms of PTSD and general psychiatric distress were reduced in women with a history of CSA participating in both analytic and systemic specialized incest group psychotherapy. Improvement was maintained for both groups at 5-year-follow-up. The trajectories of PTSD symptoms and GSI for the two groups differed significantly, however. Implications of the difference in trajectories for treatment planning will be discussed. The findings in the present study stress the importance of long-term follow-up studies in evidencebased reserch.

M3 - Poster

ER -