Coping styles in refugees with PTSD: Results from a randomized trial comparing EMDR therapy and stabilization.

BACKGROUND: While treatment of posttraumatic stress disorder (PTSD) in refugees is generally effective, many refugees remain symptomatic after treatment. Coping styles could be relevant to PTSD treatment response and as such may be a potential focus of PTSD treatment. AIMS: The study aims to examine 1) if baseline coping styles are related to treatment response after EMDR therapy or stabilization, and 2) if coping styles change during these treatments. METHOD: Seventy-two refugees with PTSD were randomly allocated to 12 hours of EMDR therapy or stabilization. A coping questionnaire (COPE-easy) and clinical interview for PTSD (CAPS-IV) were administered before and after treatment and at three-month follow-up. The association between baseline coping styles and PTSD symptom change was examined using regression analysis and a t-test. Changes in coping styles were analyzed using mixed design ANOVA. RESULTS: No significant relations between baseline coping style levels and PTSD symptom changes were found. Additionally, coping style levels did not change significantly after either treatment. CONCLUSION: Contrary to the hypothesis, we did not find any evidence that treatment was related to (changes in) coping style. Addressing pre-treatment coping styles among refugees receiving short-term therapy, may not be required for reducing PTSD. Changing coping styles may need a longer or different type of treatment.

Turning wounds into wisdom: Posttraumatic growth over the course of two types of trauma-focused psychotherapy in patients with PTSD.

BACKGROUND: Treatment studies in PTSD patients have mostly focused on adverse psychopathological outcomes whereas positive outcomes have received less attention. Objectives of this study were to investigate posttraumatic growth in response to two different psychotherapies, to examine the relationship between symptom improvement and growth, and to determine if posttraumatic growth predicted treatment response. METHODS: Outpatients diagnosed with PTSD after various types of trauma (n = 116) participated in a randomized controlled trial that compared Brief Eclectic Psychotherapy for PTSD (BEP) and Eye Movement Desensitization and Reprocessing therapy (EMDR). Posttraumatic growth was assessed pre- and post-treatment. PTSD severity was measured weekly. RESULTS: Posttraumatic growth scores significantly increased after trauma-focused psychotherapy, as well as scores in the subdomains personal strength, new possibilities, relating to others, and appreciation of life. Greater self-reported and clinician-rated PTSD decline was significantly related to greater increase in posttraumatic growth. No changes were found between treatment conditions, except for a stronger correlation between PTSD symptom decrease and increase in relating to others in BEP as compared to EMDR. No predictive effects were found. LIMITATIONS: We were unable to control for time effects because for ethical reasons, no control group not receiving treatment was included, and the stability of the changes could not be determined. CONCLUSIONS: Findings indicate that increases in posttraumatic growth accompany symptom decline in EMDR and BEP, and that these changes occur independent of whether the treatment specifically addresses posttraumatic growth as therapeutic process. Further research is encouraged to disentangle the contribution of therapeutic elements to growth.