INFLUENCE OF EMOTIONAL ENGAGEMENT AND HABITUATION ON EXPOSURE THERAPYFOR PTSD

This study examined 2 process variables, emotional engagement and habi tuation, and outcome of exposure therapy for posttraumatic stress diso rder. Thirty-seven female assault victims received treatment that invo lved repeated imaginal reliving of their trauma, and rated their distr ess at 10-min intervals. The average distress levels during each of 6 exposure sessions were submitted to a cluster analysis. Three distinct groups of clients with different patterns of distress were found: hig h initial engagement and gradual habituation between sessions, high in itial engagement without habituation, and moderate initial engagement without habituation. Clients with the Ist distress pattern improved mo re in treatment than the other clients. The results are discussed with in the framework of emotional processing theory, emphasizing the cruci al role of emotional engagement and habituation in exposure therapy.