David S. Riggs

Treatment of Posttraumatic Stress Disorder in Rape Victims: A Comparison between Cognitive-Behavioral Procedures and Counseling.

Rape victims with posttraumatic stress disorder (PTSD; N = 45) were randomly assigned to one of four conditions: stress inoculation training (SIT), prolonged exposure (PE), supportive counseling (SC), or wait-list control (WL). Treatments consisted of nine biweekly 90-min individual sessions conducted by a female therapist. Measures of PTSD symptoms, rape-related distress, general anxiety, and depression were administered at pretreatment, posttreatment, and follow-up (M = 3.5 months posttreatment). All conditions produced improvement on all measures immediately post-treatment and at follow-up. However, SIT produced significantly more improvement on PTSD symptoms than did SC and WL immediately following treatment. At follow-up, PE produced superior outcome on PTSD symptoms. The implications of these findings and direction for treatment and future research are discussed.

A Prospective Examination of Symptoms of Posttraumatic Stress Disorder in Victims of Nonsexual Assault

Symptoms of posttraumatic stress disorder (PTSD) were examined prospectively in 84 non-sexual assault victims (53 women, 31 men) beginning shortly after the assault (mean = 18.68 days) and continuing weekly for 3 months. At the initial assessment, 71% of the women and 50% of the men met symptom criteria for PTSD. The incidence of PTSD decreased to 42% of the women and 32% of the men by the fourth assessment, and at the final assessment, 21% of the women but none of the men remained with PTSD. An examination of specific PTSD symptoms indicated that many subjects who were not diagnosed with PTSD at the final assessment retained significant symptoms of PTSD, particularly reexperiencing and arousal symptoms. The severity of PTSD did decrease significantly over the course of the study, but only in those groups who were not diagnosed with the disorder at the final assessment. Women who were diagnosed with PTSD at the final assessment did not show a significant decrease in symptom severity over the course of the study. The results are discussed with regard to implications for understanding the development and persistence of posttrauma pathology, and directions for future research are outlined.

Dissociative experiences and posttraumatic stress disorder among female victims of criminal assault and rape

This study examines the relationship between posttraumatic stress disorder (PTSD) and dissociative experiences in a sample of 158 recent female assault victims (74 rape, 84 nonsexual assault) and 46 comparison subjects who had not been assaulted within the last year. Results indicated that victims had elevated scores on the Dissociative Experiences Scale (DES) as compared to the comparison subjects, but that this elevation was not as high as for other traumatized samples. The level of dissociation reported by assault victims declined significantly over the three month course of the study. DES scores were related to PTSD diagnosis and symptom severity, but only among nonsexual assault victims. In rape victims, there was no correlation between dissociation and PTSD. Recent victims with a history of childhood sexual abuse were significantly more dissociative than those who did not report such a history. These results are discussed with regard to vulnerability factors for developing PTSD subsequent to a criminal assault.

Perceived controllability and the development of posttraumatic stress disorder (PTSD) in crime victims

This study evaluated the association between perception of controllability and the development of posttraumatic stress disorder (PTSD) following criminal assault. Factor analysis of a perceived controllability scale revealed three factors; perceived controllability felt during the assault, expected controllability over future assaults, and perceived controllability over aversive events more generally. Only the latter factor was associated with PTSD symptom severity. The hypothesis that perceived controllability would be negatively associated with assault severity was partially supported. Further analyses showed that the association between controllability and PTSD was not mediated or moderated by assault severity measures. The role of perceived controllability in the development of PTSD is discussed.

Long-term psychological distress associated with marital rape and aggravated assault: A comparison to other crime victims

This study compared four groups of women who reported being the victims of a single violent crime (total N = 47) and a group of non-victimized women (N = 96). Victims were divided into groups based on the type of assault (rape vs. aggravated assault) and the identity of their assailant (husband vs. stranger). The groups were compared on measures of psychological functioning and symptoms of Post-Traumatic Stress Disorder. Crime victims reported higher levels of psychological distress than did the non-victimized women across a variety of symptom areas. There were no group differences among the four victim groups on any of the measures. Women assaulted by their husbands were more likely to report that the assault was one of a series of similar attacks. Victims of aggravated assault were more likely than rape victims to report that they feared for their lives during the assault. Results are discussed with respect to societal views on the comparative severity of marital and stranger assaults.

Relationship Problems and Dating Aggression: A Potential Treatment Target

This study investigated the association between problems in dating relationships and the occurrence of physical aggression in these relationships. A total of 667 college students (268 men, 399 women) completed the Conflict Tactics Scale (CTS) and the Relationship Problem Scale (RPS). A factor analysis of the RPS revealed seven underlying problem areas: subjects jealousy, partners jealousy, fighting, interference of friends, lack of time together, breakdown of relationship, and problems outside the relationship. Individuals who were aggressive toward their partners and those who were victims of their partners aggression reported more problems in their relationships than did individuals in nonaggressive relationships. Also, several specific problem areas such as jealousy, fighting, breakdown of the relationship, and the interference of friends were reported more often by aggressive individuals. Aggressive individuals also indicated that the problems were more severe. The results are discussed with respect to treatment and prevention programs to address the problem of dating aggression.

The Assessment of Dating Aggression Empirical Evaluation of the Conflict Tactics Scale

Two studies were conducted to examine the component structure of response patterns on the Conflict Tactics Scale in dating samples. In Study 1, CTS responses for 268 male and 399 female unmarried college students were subjected to principal components analyses. For both sexes, these analyses revealed a 4-component solution (Reasoning, Verbal Aggression/Coercion, Physical Aggression/Threat, and Severe Aggression). In Study 2, the component solution was replicated with a combined-sex sample of 288 (116 men, 172 women) unmarried college students. The component solution found in these samples was consistent with those found in earlier studies of the CTS with married samples. Differences between the empirically supported component structure and the rationally derived aggression indices for the CTS may have implications for understanding the underlying dimensions tapped by the CTS.

Marital distress and the treatment of Obsessive Compulsive Disorder

This study examined the relationship of marital distress to obsessive compulsive symptoms among 54 married subjects who were treated with exposure and response prevention for severe Obsessive Compulsive Disorder. Almost 50% of the subjects were maritally distressed prior to treatment. The level of marital distress was not, however, related to the severity of obsessive compulsive symptoms. Marital distress was significantly reduced following the three-week course of behavior therapy for subjects who were distressed initially. Forty-two percent of the individuals who were maritally distressed prior to treatment were no longer distressed following treatment. Subjects who were maritally satisfied prior to treatment showed no significant change in marital distress. All subjects reported a reduction in their level of demandingness and dependency on their spouses. In addition, the maritally distressed subjects reported fewer arguments with their partners following treatment. Changes in marital distress were unrelated to reductions in depression that also were observed following treatment. Initial levels of marital distress and depression were not related to the efficacy of the behavioral treatment for reducing symptoms of Obsessive Compulsive Disorder.