Efficacy of a two-session program of cognitive restructuring and imagery modification to reduce the feeling of being contaminated in adult survivors of childhood sexual abuse: a pilot study

Background and objectives

Cognitive restructuring and imagery modification (CRIM) to reduce the feeling of being contaminated (FBC) was tailored to adult survivors of childhood sexual abuse (CSA) suffering from this distressing feeling. A cognitive model of maladaptive appraisal and two factor learning theory can explain the development and maintenance of the FBC. CRIM combines cognitive interventions with imagery modification in a two-session treatment.

Methods

To evaluate CRIMs feasibility and efficacy, we consecutively treated 9 women suffering from chronic CSA-related posttraumatic stress disorder (PTSD) plus the FBC. Ratings regarding intensity, vividness, and uncontrollability of this feeling, and related distress as well as the Posttraumatic Diagnostic Scale (PDS) were administered prior to (t0), post (t1), and six weeks after (t2) treatment.

Results

When comparing t0 and t2 Cohen’s d was large for intensity of the FBC (d = 2.23; p < .01), its vividness (d = 1.83; p < .01), uncontrollability (d = 2.79; p < .01), and the related distress (d = 2.45; p < .01), as well as for PDS scores (d = .99; p < .05).

Limitations

Results are limited by the lack of a control group.

Conclusions

Data suggest that CRIM has the potential to reduce the FBC as well as PTSD symptoms after CSA.