PTSD AND MAJOR DEPRESSION - METHODOLOGICAL AND TREATMENT CONSIDERATIONS IN A SINGLE-CASE DESIGN

A case of successful cognitive behavioral treatment of a woman diagnos ed with assault-related posttraumatic stress disorder (PTSD) and comor bid major depression is presented. The client was treated using a comb ination of stress inoculation, cognitive restructuring, and imaginal i n vivo exposure. A statistical technique based on classical test theor y (Yarnold, 1988) was used to evaluate the client's progress in treatm ent. After 18 sessions, few statistically significant improvements wer e noted, although visual inspection of the data suggested improvements . However, after an additional six sessions devoted solely to exposure -based treatment, dramatic improvements were observed, which were main tained at one- and three-month followups. The case highlights the util ity of statistical analysis in single case designs to evaluate the cli nical decisions made in the selection of target behaviors for treatmen t of PTSD when comorbid disorders are present.