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Clinical Case Studies
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Prolonged Exposure Counterconditioning (PEC) as a Treatment for Chronic Post-Traumatic Stress Disorder and Major Depression in an Adult Survivor of Repeated Child Sexual and Physical Abuse

Nenad Paunovic

Stockholm University

Prolonged exposure counterconditioning (PEC) was tested as a treatment for chronic post-traumatic stress disorder (PTSD) in an adult survivor of repeated child sexual and physical abuse. PEC utilizes imaginal reliving of very pleasurable life moments in order to weaken traumatic conditioned emotional responses (CERs). A higher-order conditioned stimuli (CS) is used as a traumatic CER elicitor. Prolonged imaginal reliving of pleasurable CSs is used as a counterconditioner to the traumatic CERs. A statistical technique for analyzing single-case subject designs based on classical test theory was used to evaluate the client's progress in treatment. Results showed that PEC effectively decreased the client's PTSD symptoms, depression, and anxiety. In addition, the client's negative cognitions became considerably more positive. Also, the client lost his comorbid conditions of chronic major depressive disorder and social phobia. Finally, other clinically observed symptoms, which are described in the article, improved markedly. All results were maintained at a 3-month follow-up.

Key Words: PTSD • prolonged exposure counterconditioning • imaginal reliving • pleasurable CSs

Clinical Case Studies, Vol. 1, No. 2, 148-169 (2002)
DOI: 10.1177/1534650102001002004
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