Cognitive restructuring and imagery modification for posttraumatic stress disorder (CRIM-PTSD): A pilot study. (March 2017) - Müller-Engelmann, Meike
Abstract: Background and objectives: Cognitive restructuring and imagery modification for PTSD (CRIM-PTSD) is a new short intervention. It consists of the cognitive restructuring of core trauma-related dysfunctional beliefs about the self and the use of imagery to encourage more functional beliefs. A randomized controlled trial showed that CRIM was effective for reducing posttraumatic stress disorder (PTSD) in survivors of childhood sexual abuse (CSA) when it focused on the feeling of being contaminated. For this study, CRIM was adapted to treat PTSD symptoms more generally and after various types of trauma by addressing the patients' negative self-concept. Methods: Ten patients with PTSD received two assessment sessions, two treatment sessions, and a booster session. The Clinician-Administered PTSD Scale (CAPS) was administered prior to and four weeks after treatment. Self-ratings, e.g., the Posttraumatic Diagnostic Scale (PDS) and the Posttraumatic Cognitions Inventory (PTCI), were administered at baseline, immediately posttreatment, and four weeks after treatment. Results: The participants showed significant improvements in both clinician-rated (d = 2.55; p < 0.01) and self-reported PTSD symptoms (d = 1.47; p < 0.01). One month after treatment, 9 patients no longer fully met the diagnostic criteria for PTSD. Limitations: The results are limited by the small sample size and the lack of a control group. Conclusions: This pilot study suggests that addressing the negative self-concept of PTSD patients using a combination of cognitive techniques and imagery modification can effectively reduce PTSD symptoms. Further research is needed to assess the treatment's effects and stability in a randomized controlled trial. Highlights: We used cognitive restructuring and imagery modification to treat PTSD symptoms. The focus of the intervention was on the patients' negative self-concept. We conducted a pilot study with 10 patients. At the follow-up, the CAPS scores and self-ratings indicated a reduction in PTSD symptoms. Nine of the 10 patients no longer fully met the diagnostic criteria for PTSD at follow-up.