EFFECTIVENESS OF DIALECTICAL BEHAVIOUR AND COGNITIVE PROCESSING THERAPIES IN THE REDUCTION OF EMOTIONAL STRESS AMONG SEXUALLY ABUSED FEMALE ADOLESCENTS
Keywords:
Dialectical Behaviour Therapy, Cognitive Processing Therapy, Emotional Stress,Abstract
 This study examined the effectiveness of Dialectical Behaviour (DBT) and Cognitive Processing Therapies (CPT) in the reduction of emotional stress and moderating effects of resilience and age among sexually abused female adolescents in Ibadan metropolis. A Pretest-posttest control group, quasi-experimental design with a 3×2×3 factorial matrix was adopted. 78 participants were randomly assigned to eight weeks of intervention. Child Sexual Abuse Index (r= 0.96) for screening, Revised Impact of Events (r=0.90) and Resilience (r=0.78) were used for data collection. Analysis of Covariance and Scheffe posthoc test analysis showed a significant main effect of treatments (F (2, 66) = 5.42, η2 = 0.14) and resilience (F (2, 66) = 3.43, η2 = 0.07) on emotional stress. CPT (xÌ…= 39.16) reported a higher reduction in emotional stress levels than DBT (xÌ…= 39.95) and control (xÌ…= 56.29) groups. A two-way significant interaction effect of treatment and resilience (F (2, 66) = 4.22, η2 = 0.11) and treatment and age on emotional stress (F (2, 66) = 3.35, η2 = 0.09) was reported. DBT and CPT were effective in reducing emotional stress, while resilience moderated the effect of emotional stress hence the two therapies and resilience skills training should be incorporated into the treatment regimen for sexually abused female adolescents in Nigeria.ÂReferences
Alink, L.R, Cicchetti, D., Kim, J., & Rogosch F.A. (2012). Longitudinal associations among child maltreatment, social functioning, and cortisol regulation. Developmental Psychology; 48(1):224-36. doi: 10.1037/a0024892. Epub 2011 Aug 8. PMID: 21823793; PMCID: PMC3400182.
Allnock, D. & Hynes, P. (2011). Therapeutic Services for Sexually Abused Children and Young People: Scoping the Evidence Base, NSPCC, London
Anda, R. F., Felitti, V. J., Bremner, J. D., Walker, J. D., Whitfield, C., Perry, B. D. & Giles, W. H. (2006). The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience, 256(3), 174–186. doi:10.1007/s00406-005-0624-4
Anda, R., Tietjen, G., Schulman, E., Felitti, V., & Croft, J. (2010). Adverse childhood experiences and frequent headaches in adults. Headache, 50(9), 1473–1481. doi:10.1111/j.1526-4610.2010.01756.
Bonanno, G. A. (2005). Loss, trauma, and human resilience: have we underestimated the human capacity to thrive after extremely aversive events? American psychologist, 59(1), 20.
Brilleslijper-Kater, S. N., Friedrich, W. N., & Corwin, D. L. (2004). Sexual knowledge and emotional reaction as indicators of sexual abuse in young children: theory and research challenges. Child Abuse & Neglect, 28(10), 1007-1017.
Chard, K. M.(2005).An evaluation of cognitive processing therapy for the treatment of posttraumatic stress disorder related to childhood sexual abuse. Journal of consulting and clinical psychology, 73(5), 965.
Chard, K. M., Schumm, J. A., McIlvain, S. M., Bailey, G. W., & Parkinson, R. B. (2011). Exploring the efficacy of a residential treatment program incorporating cognitive processing therapyâ€cognitive for veterans with PTSD and traumatic brain injury. Journal of traumatic stress, 24(3), 347-351.
Chen, L. P., Murad, M. H., Paras, M. L., Colbenson, K. M., Sattler, A. L., Goranson, E. N., ... & Zirakzadeh, A.
(2010). Sexual abuse and lifetime diagnosis of psychiatric disorders: systematic review and meta-
analysis. In Mayo Clinic Proceedings, 85(7), 618- 629.
Cohn, M., Fredrickson, B., Brown, S., Mikels, J., Conway, A. (2009). Happiness unpacked: Positive emotions
increase life satisfaction by building resilience, Emotion,9, 361–368.
Coles, J. Y., Lee, A. K., Taft, A., Mazza, D., & Loxton, D. (2015). Childhood sexual abuse and its association with adult physical and mental health: results from a national cohort of young Australian women. Journal of Interpersonal Violence, 30(11), 1929 - 1944. https://doi.org/10.1177/0886260514555270
Creeden, K. (2009). How trauma and attachment can impact neurodevelopment: Informing our understanding and
treatment of sexual behaviour problems Journal of Sexual Aggression, 15.(3). 261-273
Dimeff, L. A., & Linehan, M. M. (2008). Dialectical behaviour therapy for substance abusers. Addiction science & clinical practice, 4(2), 39.
Dimeff, L., Rizvi, S. L., Brown, M., & Linehan, M. M. 2000. Dialectical behavior therapy for substance abuse: A pilot application to methamphetamine-dependent women with borderline personality disorder. Cognitive and Behavioural Practice, 7, 457-468.
Doherr, L., Reynolds, S.,Wetherly, J., & Evans, E. H. (2005). Young children’s ability to engage in cognitive therapy
tasks: associations with age and educational experience. Behavioural and Cognitive Psychotherapy, 33,
–215
Dray, J., Bowman, J., Freund, M., Campbell, E., Wolfenden, L., Hodder, R. K., & Wiggers, J. (2014). Improving adolescent mental health and resilience through a resilience-based intervention in schools: study protocol for a randomised controlled trial. Trials, 15(1), 289.
Dumbleton, T. (2005). Dealing with Emotional Stress; The Hardest Thing in the World? Retrieved April 15, 2008.
Galovski, T.E., Blain, L.M., Mott, J.M., Elwood, L., & Houle, T. (2012). Manualized therapy forGomes-Schwartz, B., Horowitz, J. M., & Sauzier, M. (1985). Severity of emotional distress among sexually abused preschool, school-age, and adolescent children. Psychiatric Services, 36(5), 503-508.
Hillberg, T., Hamilton-Giachritsis, C., & Dixon, L. (2011). Review of meta-analyses on the association between child
sexual abuse and adult mental health difficulties: A systematic approach. Trauma, Violence, & Abuse, 12,
–49. https://doi.org/10.1177 /1524838010386812
Hjemdal O, Aune T, Reinfjell T, Stiles T.C, & Friborg O. (2007). Resilience as a predictor of depressive symptoms: a
correlational study with young adolescents. Clinical Child Psychology Psychiatry; 12(1):91-104.
doi: 10.1177/1359104507071062. PMID: 17375811.
Hjemdal, O., Vogel, P. A., Solem, S., Hagen, K., & Stiles, T. C. (2011). The relationship between resilience and levels of anxiety, depression, and obsessive–compulsive symptoms in adolescents. Clinical psychology & psychotherapy, 18(4), 314-321.
Hodgkinson, P., & Joseph, S. 1995. Factor analysis of the Impact of Events Scale with female Bank staff following an armed robbery raid. Personality and Individual Differences, 19(5), 773- 775.
Ibeagha, P. N., Balogun, S. K., & Adejuwon, G. A. (2004). Resiliency of Inner-City Yoruba University Undergraduates in South Western Nigeria. Kamla-Raj Studies of Tribes and Tribals, 2(2), 125-129.
Jonzon, E., & Lindblad, F. (2006). Risk factors and protective factors in relation to subjective health among adult female
victims of child sexual abuse. Child abuse & neglect, 30(2), 127-143
Kendall-Tackett, K. (2009). Psychological trauma and physical health: A psychoneuroimmunology approach to etiology of negative health effects and possible interventions. Psychological Trauma: Theory, Research, Practice, and Policy, 1(1), 35–48. https://doi.org/10.1037/a0015128
Kendall-Tackett, K. A., Williams, L. M., & Finkelhor, D. (1993). Impact of sexual abuse on children: a review and synthesis of recent empirical studies. Psychological bulletin, 113(1), 164.
Koerner, K., & Dimeff, L. A. (2007). Overview of dialectical behavior therapy. In L. A. Dimeff & K. Koerner (Eds.), Dialectical behavior therapy in clinical practice: Applications across disorders and settings (p. 1–18). Guilford Press.
Lansford, J. E., Malone, P. S., Stevens, K. I., Dodge, K. A., Bates, J. E., & Pettit, G. S. (2006). Developmental trajectories of externalizing and internalizing behaviours: Factors underlying resilience in physically abused children. Development and psychopathology, 18(01), 35-55.
Lazarus, R. S. (1991). Progress on a cognitive-motivational-relational theory of emotion. American Psychologist, 46(8), 819–834. https://doi.org/10.1037/0003-066X.46.8.819
Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.
Masten, A.S. & Powell, J.L. (2003). A resilience framework for research, policy and practice. In S.S. Luther (Eds.),
Resilience and Vulnerability: Adaptation in the context of childhood adversities (pp.1-25). New York: Cambridge
University Press.
McMain, S, Korman, L.M, Dimeff L. (2001) Dialectical behaviour therapy and the treatment of emotion dysregulation. Journal of Clinical Psychology ;57(2):183-96. doi: 10.1002/1097-4679(200102)57:2<183::aid-jclp5>3.0.co;2-y. PMID: 11180146.
Monson, C.M., Schnurr, P.P., Resick, P.A., Friedman, M.J., Young-Xu, Y., & Stevens, S.P. (2006). Cognitive processing therapy for veterans with military-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 74, 898–907. doi:10.1037/0022-006X.74.5.898
Monson, C.M., Schnurr, P.P., Resick, P.A., Friedman, M.J., Young-Xu, Y., & Stevens, S.P. (2006). Cognitive processing therapy for veterans with military-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 74, 898–907. doi:10.1037/0022-006X.74.5.898
Naglieri, J. A., LeBuffe, P. A., & Ross, K. M. (2013). Measuring resilience in children: From theory to practice. In
Handbook of resilience in children (pp. 241-259). Springer US.
National Scientific Council on the Developing Child, (2007). The timing and quality of early experiences combine to shape brain architecture. Working paper 5. Cambridge, MA: Center on the Developing Child at Harvard University. retrieved 7 March 2013, http://developingchild.harvard.edu/index.php/resources/reports_and_working_papers/working_papers/wp5/
Ogundayo, D.A. (2007). Dialectical Behaviour and Acceptance-Commitment Strategies for enhancing social competence among spiritually-abused adolescents in Ibadan Unpublished dissertation. Guidance and Counselling, University of Ibadan
Oliver, K. G., Collin, P., Burns, J., & Nicholas, J. (2006). Building resilience in young people through meaningful participation. Australian e-Journal for the Advancement of Mental Health, 5(1), 34-40.
PTSD: Flexing the structure of cognitive processing therapy. Journal of Consulting and Clinical Psychology, 80, 968–981. doi:10.1037/a0030600
Rathus, J. H., & Miller, A. L. (2002). Dialectical behaviour therapy adapted for suicidal adolescents. Suicide and life-
threatening behaviour, 32(2), 146-157
Resick, P. A., Monson, C. M., & Chard, K. M. (2007). .Cognitive processing therapy for PTSD: A comprehensive
manual. The Guilford Press
Resick, P.A, Wachen, J.S, & Dondanville K.A, et al. (2017). Effect of Group vs Individual Cognitive Processing Therapy in
Active-Duty Military Seeking Treatment for Posttraumatic Stress Disorder: A Randomized Clinical Trial. JAMA
Psychiatry.74 (1):28–36.doi:10.1001/ jamapsychiatry.2016 .2729
Resick, P.A., & Schnicke, M.K. (1992). Cognitive processing therapy for sexual assault victims.
Resick, P.A., Nishith, P., Weaver, T.L., Astin, M.C., & Feuer, C.A. (2002). A comparison of
Rosner R, Rimane E, Frick U, et al. Effect of Developmentally Adapted Cognitive Processing Therapy for Youth with Symptoms of Posttraumatic Stress Disorder after Childhood Sexual and Physical Abuse: A Randomized Clinical Trial. JAMA Psychiatry. 2019; 76(5):484–491. doi:10.1001/jamapsychiatry.2018.4349
Rudow, D.L, Iacoviello, B.M, & Charney D. (2014). Resilience and personality traits among living liver and kidney donors.
Prog Transplant.; 24(1):82-90. doi: 10.7182/pit2014448. PMID: 24598570.
Sawyerr, S. M. (2007). Defining patterns of genital injury from sexual assault: a review. Trauma violence and abuse, 8(3), 270-280.
Steil, R., Dyer, A., Priebe, K., Kleindienst, N., & Bohus, M. (2011). Dialectical behavior therapy for posttraumatic
stress disorder related to childhood sexual abuse: a pilot study of an intensive residential treatment program
. Journal of traumatic stress, 24(1), 102-106.
Steyn, G. M., & Kamper, G. D. (2006). Understanding occupational stress among educators: an overview. Africa
Education Review, 3(1-2), 113-133.
Stoltenborgh, M., van IJzendoorn, M. H., Euser, E. M., & Bakermans-Kranenburg, M. J. (2011). A Global Perspective
on Child Sexual Abuse: Meta-Analysis of Prevalence around the World. Child Maltreatment, 16, 79-
http://dx.doi.org/10.1177/1077559511403920
Swales, Heidi L. Heard, J. Mark G. Williams, M. (2000). Dialectical Behaviour Therapy (DBT) for borderline personality disorder: Overview and adaptation. Journal of Mental Health, 9(1), 7-23.
Underwood, L., Stewart, S. E., & Castellanos, A. M. (2007). Effective practices for sexually traumatized girls:
Implications for counselling and education. International Journal of Behavioural Consultation and Therapy,
(3), 403.
Wagnild, G. M., & Young, H. M. (1993). Development and psychometric evaluation of the resilience scale. Journal of
Nursing Measurement, 1(2), 165-178.
Waller, M. A., & Okamoto, S. K., Miles, B.W, & Hurdle D.E (2003). Resiliency factors related to substance
use/resistance: Perceptions of Native adolescents of the Southwest. Journal of Sociology & Social Welfare,
, 79-94.
Weiss, D. S., & Marmar, C. R. (1997). The Impact of Event Scale—Revised. In J. P. Wilson & T. M. Keane (Eds.), Assessing psychological trauma and PTSD (p. 399–411). The Guilford Press.
Wolfe, V. V., Gentile, C., & Wolfe, D. A. (1989). The impact of sexual abuse on children: A PTSD formulation.
Behaviour Therapy, 20(2), 215-228.
Woodberry, K. A., & Popenoe, E. J. (2008). Implementing dialectical behavior therapy with adolescents and their
families in a community outpatient clinic. Cognitive and Behavioural Practice, 15(3), 277-286.
Xing, X. P., Wang, M. F., Zhang, Q., He, X. R., & Zhang, W. X. (2011). Gender differences in the reciprocal relationships between parental physical aggression and children’s externalizing problem behavior in China. Journal of Family Psychology, 25, 699-708.
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