How Cognitive Psychology With Cognitive Restructuring Impacts Rape Victims

¶ … Cognitive Restructuring on Rape Victims

Recently, the growing numbers of research have been focused on psychological trauma which can be caused by physical, sexual and life threatening events. The survivors of traumatic events would exhibit great variation of symptoms, especially, self-blaming, guilt, negative beliefs about self and others, cognitive distortions, and inaccurate thoughts related to their traumatic experiences. Sobel, Resick and Rabalais (2009) proposed a cognitive processing therapy (CPT) to reduce the posttraumatic stress disorder symptoms and increase the positive thought and accurate cognition of the survivors. In this seminal paper, they reviewed the literature, classified the syndromes before and after the CPT, reported the statistical results and suggested a cognitive restructuring method. Cognitions are assessed using coding and analyzing the participants' statements before and after the therapy and the scaling systems used are the Clinician-Administered PTSD Scale and PTSD Symptom Scale. They scaled two cognitive processes, accommodation, and assimilation adopting the cognitive processing theories of McCann and Pearlman (1990), and Resick and Schnicke (1993).These studied suggested assimilation or accommodation processes occurs when individuals are confronted with new information that is inconsistent with previous cognitive experiences. Accommodation involves the modification of existing schemas to incorporate new events and information. Although accommodation is essential to integrate new information and previous information, over accommodation would have some negative effects in the aspect of overgeneralization and inaccurate cognition. Assimilation is defined as incorporating or altering the new information to fit into preexisting cognitive structures. The threat for assimilation is previous assumptions (e.g., self-blame). The writes scaled the changes in assimilation, accommodation and overaccomodation in the aspects of agency, safety, trust, power, esteem, and intimacy before and after the CPT. It was hypothesized that CPT would be associated with reductions in posttraumatic stress disorder (PTSD) symptoms and problematic (i.e., assimilated and overaccommodated) thoughts as well as increases in the number of realistic (i.e., accomodation) cognitions. Thirty-seven female rape survivors were evaluated.

The tools were the Clinician-Administered PTSD Scale (CAPS) and the PTSD Symptom Scale (PSS). The CAPS is a 22-item structured interview used to obtain a PTSD diagnosis providing the rate of the frequency and intensity of each PTSD symptom on a 0 -- 4 scale. For each symptom, a frequency rating of 1 or higher along with an intensity rating of 2 or higher is considered to be clinically significant. The addition of frequency and intensity provides the CAPS result. PSS is a 17-item self-report scale that measures the reexperiencing, avoidance/numbing, and arousal symptoms of PTSD.

A manual was developed for homogenous evaluations. The manual included the definitions of accommodation, assimilation and overaccommodations along with the processes which are not the part of scaling. Three coders (i.e., two doctoral-level fellows and a graduate student) interviewed the participants using the criteria defined in the manual. The results were analyzed by repeated measures of MANOVA.

The writers suggested that it was possible to observe, record, and reliably code the number and percentage of assimilated, overaccommodated, and accommodated statements that rape survivors produced in their impact statements at the beginning and end of a course of CPT. As hypothesized, there were significant decreases in the overaccommodated and assimilated processes from start to the end of therapy whereas there was an increase in the accommodated processes. Although there was a clear relationship between decreased PTSD and accommodation, this study was not able to make a clear statement about the relationship between assimilation and PTSD. Another limitation of this study is the ethnicity classification because of the limited number of participants.