The Effectiveness of Emotion-Focused Therapy for Trauma on Executive Functions in individuals with Sexual Trauma (Case Report)

Document Type : Research Paper

Authors

1 Department of Psychology and Education of Exceptional Children, Psychology and Educational Science Faculty, University of Tehran, Tehran, Iran.

2 Department of Psychology, psychology and Educational Science Faculty, Payam-e Noor University of Tehran, Tehran, Iran

Abstract

The purpose of this study was to examine the impact of emotion-focused therapy on executive functions in individuals who have experienced sexual trauma. The target population was all sexually assaulted individuals who visited the Iran Trauma Institute in Mashhad in 2021. The research method was practical in nature, and the data collection was quantitative and experimental. Three of the ten individuals selected as samples were women, as determined by the entry criteria. Childhood trauma questionnaires (CTQ), Emotional visual working memory capacity (EVWMC) were implemented in this investigation. Visual analysis of the graphs depicting the changes in the research variables and the effect size of each variable on the clients, as well as the percentage of improvement and the percentage of reduction in their score changes, were employed to conduct the data analysis using the appropriate formulas in the SPSS-26 software. The effect sizes of emotion-focused therapy of trauma (EFTT) on the working memory capacity of individuals with sexual trauma were relatively high in all three participants during both the intervention and follow-up periods. The results indicated that EFTT enhanced the executive function of working memory capacity in sexually traumatized individuals from a clinical perspective, thereby preventing sexual revictimization.

Keywords

References

ابراهیمی، ح.، دژکام، م.، و ثقه‌الاسلام، ط. (1392). تروماهای دوران کودکی و اقدام به خودکشی در بزرگسالی. مجلۀ روان‌پزشکی و روان‌شناسی بالینی ایران. 19(4)، ۲۷۵-۲۸۲. http://ijpcp.iums.ac.ir/article-1-2090-fa.html
میرابوالفتحی، و. (۱۳۹۴). بررسی و مقایسۀ عملکرد افراد مبتلا به PTSD و افسردگی در ظرفیت حافظۀ فعال دیداری هیجانی. پایان‌نامۀ کارشناسی ارشد روان‌شناسی بالینی. دانشکدۀ روان‌شناسی. دانشگاه علوم پزشکی و خدمات بهداشت درمانی شهید بهشتی.
References
American Psychiatric Association (2022). Diagnostic and statistical manual of mental disorders (5th Ed.). Text Revision. Arlington, VA: American Psychiatric Association.
American Psychological Association (2008). Presidential Task Force on Posttraumatic Stress Disorder and Trauma in Children and Adolescents Children and Trauma: Update for Mental Health Professionals. Washington, DC: American Psychological Association. https://www.apa.org/pi/families/resources/update.pdf
Augusti, E. M., & Melinder, A. (2013). Maltreatment is associated with specific impairments in executive functions: A pilot study: Executive functions in maltreated children. Journal of Traumatic Stress, 26(6), 780 –783. https://doi.org/10.1002/jts.21860.
Baddeley, A. (2013). Essentials of Human Memory (Classic Edition) (1st Ed.). London: Taylor & Francis. https://doi.org/10.4324/9780203587027
Bernstein, D. P., Stein, J. A., Newcomb, M. D., Walker, E., Pogge, D., … Desmond, D., & Zule, W. (2003). Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse and Neglect, 27(2), 169-190. https://doi.org/10.1016/s0145-2134(02)00541-0
Bogat, G. A., Garcia, A. M., & Levendosky, A. A. (2013). Assessment and psychotherapy with women experiencing intimate partner violence: Integrating research and practice. Psychodynamic Psychiatry, 41(2), 189–217 https://doi.org/10.1521/pdps.2013.41.2.189
Bücker, J., Kapczinski, F., Post, R., Ceresér, K. M., Szobot, C., … & Kauer-Sant'Anna, M. (2012). Cognitive impairment in school-aged children with early trauma. Comprehensive Psychiatry, 53(6), 758–764. https://doi.org/10.1016/j.comppsych.2011.12.006
Carr, C. P., Martins, C. M. S., Stingel, A. M. S., Lemgruber, V. B., & Juruena, M. F. (2013). The role of early life stress in adult psychiatric disorders: A systematic review according to childhood trauma subtypes. Journal of Nervous and Mental Disease, 201(12), 1007–1020. https://doi.org/10.1097/NMD.0000000000000049
Cashmore, J., & Shackel, R. (2013). The long-term effects of child sexual abuse. CFCA paper no. 11. Australian Institute of Family Studies. Retrieved from: https://formerministers.dss.gov.au/13217/long-term-impacts-of-child-sexual-abuse/
Chard, K. (2005). An evaluation of cognitive processing therapy for the treatment of posttraumatic stress disorder related to child sexual abuse. Journal of Consulting and Clinical Psychology, 73(5), 965-971. https://doi.org/10.1037/0022-006X.73.5.965
Classen, C. C., Palesh, O. G., & Aggarwal, R. (2005). Sexual revictimization: A review of the empirical literature. Trauma, Violence & Abuse, 6(2), 103–129. https://doi.org/10.1177/1524838005275087
Cloitre, M., Koenen, K. C., Cohen, L. R., & Han, H. (2002). Skills training in affect and interpersonal regulation followed by exposure: A phase-based treatment for PTSD related to childhood abuse. Journal of Consulting and Clinical Psychology, 70(5), 1067-1074. https://doi.org/10.1037/0022-006X.70.5.1067
Damasio A. R. (1995). On some functions of the human prefrontal cortex. Annals of the New York Academy of Sciences, 769, 241–251. https://doi.org/10.1111/j.1749-6632.1995.tb38142.x
DePrince, A. P., Weinzierl, K. M., & Combs, M. D. (2009). Executive function performance and trauma exposure in a community sample of children. Child Abuse & Neglect, 33(6), 353–361. https://doi.org/10.1016/j.chiabu.2008.08.002
Diamond, A. (2013). Executive functions. Annual Review of Psychology, 64, 135–168. https://doi.org/10.1146/annurev-psych-113011-143750
Ebrahimi, H., Dezhkam, M., & Thagha Al-Islam, T. (2014) Childhood traumas and suicide attempts in adulthood. Iranian Journal of Psychiatry and Clinical Psychology, 19(4), 282-275. http://ijpcp.iums.ac.ir/article-1-2090-en.html (In Persian)
Evans, M., Malpass, A., Agnew-Davies, R., & Feder, G. (2018). Women’s experiences of a randomised controlled trial of a specialist psychological advocacy intervention following domestic violence: A nested qualitative study. PLoS ONE, 13(11), 1–11. https://doi.org/10.1371/journal.pone.0193077
Foa, E. B., Huppert, J. D., & Cahill, S. P. (2006). Emotional processing theory:An update.In B. O. Rothbaum (Ed), Pathological anxiety: Emotional processing in etiology and treatment (pp.3-24). New York: Guilford Press. https://psycnet.apa.org/record/2005-16244-001
Gleiser, K., Ford, J. D., & Fosha, D. (2008). Contrasting exposure and experiential therapies for complex posttraumatic stress disorder. Psychotherapy: Theory, Research, Practice, Training, 45(3), 340–360. https://doi.org/10.1037/a0013323
Goldstein, A.L., Faulkner, B., & Wekerle, C. (2013). The relationship among internal resilience, smoking, alcohol use, and depression symptoms in emerging adults transitioning out of child welfare. Child Abuse & Neglect, 37(1), 22–32. https://doi.org/10.1016/j.chiabu.2012.08.007
Greenberg, L. S, & Paivio, S. C. (1997). Working with the emotions in psychotherapy. New York: Guilford.
Greenberg, L. S., & Watson, J. C. (2006). Emotion focused therapy for depression. Washington, DC: American Psychological Association. https://www.apa.org/pubs/books/4317081
Greenberg, L. S. (2015). Emotion-focused therapy: Coaching clients to work through their feelings (2nd Ed.). Washington, DC: American Psychological Association. https://doi.org/10.1037/14692-000
Herman, H. J. M. (1996). Voicing the self: From information processing to dialogical interchange. Psychological Bulletin,119,31-50. https://doi.org/10.1037/0033-2909.119.1.31
Hodgdon, H. B., Liebman, R., Martin, L., Suvak, M., Beserra, K., … & Spinazzola, J. (2018). The effects of trauma type and executive dysfunction on symptom expression of polyvictimized youth in residential care: Trauma type and executive dysfunction. Journal of Traumatic Stress, 31(2), 255–264. https://doi.org/10.1002/jts.22267
Ingram, R. E., Hayes, A., & Scott, W. (2000). Empirically supported treatment: A critical analysis. In. C. R. Snyder & Q. R. E. Ingram (Eds.). Handbook of psychological change (pp. 40-60). New York: Wiley.
Kirke-Smith, M., Henry, L. A., & Messer, D. (2016). The effect of maltreatment type on adolescent executive functioning and inner speech: Maltreatment type, EF and inner speech. Infant and Child Development, 25(6), 516-532. https://doi.org/10.1002/icd.1951
Lazarus, R. S. (1991). Progress on a cognitive-motivational-relational theory of emotion. American Psychologist, 46, 819-834. https://doi.org/10.1037//0003-066x.46.8.819
Maniglio, R. (2009). The impact of child sexual abuse on health: a systematic review of reviews. Clinical Psychology Review, 29(7), 647–657. https://doi.org/10.1016/j.cpr.2009.08.003
Maniglio, R. (2015). Significance, nature, and direction of the association between child sexual abuse and conduct disorder: A systematic review. Trauma, Violence, & Abuse, 16(3), 241-257. http://dx.doi.org/10.1177/1524838014526068
Martin, L., Kidd, M., & Seedat, S. (2019). The effects of childhood maltreatment and anxiety proneness on neuropsychological test performance in non-clinical older adolescents. Journal of Affective Disorders, 243, 133-144. https://doi.org/10.1016/j.jad.2018.09.009
Messman-Moore, T. L., Walsh, K.L., & DiLillo, D. (2010). Emotion dysregulation and risky sexual behavior in revictimization. Child Abuse & Neglect, 34(12), 967–976. https://doi.org/10.1016/j.chiabu.2010.06.004
Mirabolfathi, V. (2014), Examining and comparing the performance of people with PTSD and depression in visual emotional working memory capacity. Master's Thesis. Faculty of Psychology, Shahid Beheshti University of Medical Sciences and Health Services. (In Persian)
Moradi, A. R., Taghavi, R., Neshat-Doost, H. T., Yule, W., Dalgleish, T. (2000). Memory bias for emotional information in children and adolescents with posttraumatic stress disorder: A preliminary study. Journal of Anxiety Disorders, 14(5), 521-534. https://doi.org/10.1016/S0887-6185(00)00037-2
Moradi, A. R., Herlihy, J., Yasseri, G., Shahraray, M., Turner, S., & Dalgleish, T. (2008).Specifity of episodic and semantic aspects of autobiographical memory in relation tosymptoms of posttraumatic stress disorder. Acta Psychologica, 127, 645-653. https://doi.org/10.1016/j.actpsy.2007.11.001
Morey, C. C. (2018). The case against specialized visual-spatial shortterm memory. Psychological Bulletin, 144(8), 849–883. https://doi.org/10.1037/bul0000155
Morey, R. A., Dolcos, F., Petty, C. M., Cooper, D. A., Hayes, J. P., … & McCarthy, G. (2009). The role of trauma-related distractors on neural systems for working memory and emotion processing in posttraumatic stress disorder. Journal of Psychiatric Research, 43(8), 809-817. https://doi.org/10.1016/j.jpsychires.2008.10.014
Paivio, S. C., & Pascual-Leone, A. (2023). Emotion-focused therapy for complex trauma: An integrative approach (2nd Ed.). American Psychological Association. http://www.jstor.org/stable/j.ctv2x6dzgs
Paivio, S. C., & Shimp, L. N. (1998). Affective change processes in therapy for PTSD stemming from childhood abuse. Journal of Psychotherapy Integration, 8, 211–229. https://doi.org/10.1023/A:1023265103791
Paivio, S. C., & Greenberg, L. S. (1995). Resolving ‘‘unfinished business’’: Efficacy of experiential therapy using empty-chair dialogue. Journal of Consulting and Clinical Psychology, 63, 419-425. https://doi.org/10.1037/0022-006X.63.3.419
Paivio, S. C., & Nieuwenhuis, J. A. (2001). Efficacy of emotion focused therapy for adult survivors of childhood abuse: A preliminary study. Journal of Traumatic Stress, 14(1), 115-133. https://doi.org/10.1023/A:1007891716593
Paivio, S. C., & Patterson, L. A. (1999). Alliance development in therapy with adult survivors of child abuse. Psychotherapy: Theory, Research, Practice, Training, 36, 343 354. https://doi.org/10.1037/h0087843
Paivio, S. C., Hall, I., Holowaty, K., Jellis, J., & Tran, N. (2001). Imaginal confrontation for resolving child abuse issues. Psychotherapy Research, 11(4), 433 453. https://doi.org/10.1093/ptr/11.4.433
Paivio, S. C., Holowaty, K. A. M., & Hall, I. (2004). The influence of therapist adherence and competence on client reprocessing of child abuse memories. Psychotherapy: Theory, Research, Practice, and Training, 41, 56-68. https://doi.org/10.1037/0033-3204.41.1.56
Paivio, S. C., Jarry, J. L., Chagigiorgis, H., Hall, I., & Ralston, M. (2010). Efcacy of two versions of emotion-focused therapy for resolving child abuse trauma. Psychotherapy Research, 20(3), 353–366. https://doi.org/10.1080/10503300903505274
Perna, R. B., & Kiefner, M. (2013). Long-term cognitive sequelae: abused children without PTSD. Applied Neuropsychology: Child, 2(1), 1–5. https://doi.org/10.1080/09084282.2011.595460
Resick, P. A., Nishith, P., & Griffin, M. G. (2003). How well does cognitive-behavioral therapy treat symptoms of complex PTSD? An examination of child abuse survivors within a clinical trial. CNS Spectrums, 8(5), 340-355. https://doi.org/10.1017/S1092852900018605
Savitz, J. B., Van Der Merwe, L., Stein, D. J., Solms, M., & Ramesar, R. S. (2008). Neuropsychological task performance in bipolar spectrum illness: genetics, alcohol abuse, medication and childhood trauma. Bipolar Disorders, 10(4), 479–494. https://doi.org/10.1111/j.1399-5618.2008.00591.x
Schweizer, S., & Dalgleish, T. (2011). Emotional working memory capacity in posttraumatic stress disorder (PTSD). Behaviour Research and Therapy, 49(8), 498-504. https://doi.org/10.1016/j.brat.2011.05.007
Solomon, M. F., & Siegel, D. J. (Eds.). (2003). Healing trauma: Attachment, mind, body, and brain. New York: W.W.
Talbot, N. L., & Gamble, S. A. (2008). IPT for women with trauma histories in community mental health care. Journal of Contemporary Psychotherapy, 38, 35-44. https://doi.org/10.1007/s10879-007-9066-9
Timulak, L., & Keogh, D. (2020). Emotion-focused therapy: A transdiagnostic formulation. Journal of Contemporary Psychotherapy, 50, 1–13. https://doi.org/10.1007/s10879-019-09426-7
Tranel D. (1992). Neuropsychological assessment. Psychiatric Clinics of North America, 15(2), 283–299. https://psycnet.apa.org/record/1993-04130-001.
Vasilevski, V., & Tucker, A. (2016). Wide-ranging cognitive deficits in adolescents following early life maltreatment. Neuropsychology, 30(2), 239 –246. https://doi.org/10.1037/neu0000215
Walker, H. E., Freud, J. S., Ellis, R. A., Fraine, S. M., & Wilson, L. C. (2017). The prevalence of sexual revictimization: A meta-analyticreview. Trauma, Violence, & Abuse, 20, 67–80. https://doi.org/10.1177/1524838017692364
Warshaw, C., Sullivan, C. M., & Rivera, E. A. (2013). A systematic review of trauma-focused interventions for domestic violence survivors. Chicago: National Collaborating Center for Domestic Violence, Trauma and Mental Health. https://anrows.intersearch.com.au/anrowsjspui/handle/1/19630
Wong, C. F., Clark, L. F., & Marlotte, L. (2016). The impact of specific and complex trauma on the mental health of homeless youth. Journal of Interpersonal Violence, 31(5), 831–854. https://doi.org/10.1177/0886260514556770
Jakubowska, B., & Pragłowska, E. (2015). Diagnosis of posttraumatic stress disorder (PTSD) by the structured clinical interview SCID-I. Psychiatr. Pol, 49(1), 159-169. http://dx.doi.org/10.12740/PP/32214
Journal of Applied Psychological Research
Volume 15, Issue 2
2024
Pages 235-251

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History

  • Receive Date: 15 May 2023
  • Revise Date: 02 August 2023
  • Accept Date: 26 August 2023
  • First Publish Date: 21 June 2024
  • Publish Date: 21 June 2024

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