Intrusive memory frequency and related inner tension following dialectical behavior therapy or cognitive processing therapy for posttraumatic stress disorder: an e-diary study
Background: Intrusive memories are a core symptom of posttraumatic stress disorder (PTSD), yet their retrospective assessment is prone to biases, making real-time methods such as e-diaries essential. While trauma-focused treatments target intrusive symptoms, their efficacy has not yet been evaluated...
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| Hauptverfasser: | , , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
08.Dec.2025
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| In: |
JMIR mental health
Year: 2025, Jahrgang: 12, Pages: 1-9 |
| ISSN: | 2368-7959 |
| DOI: | 10.2196/81081 |
| Online-Zugang: | Verlag, kostenfrei, Volltext: https://doi.org/10.2196/81081 Verlag, kostenfrei, Volltext: https://mental.jmir.org/2025/1/e81081 
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| Verfasserangaben: | Sara E Schmitz, PhD, Ulrich W Ebner-Priemer, Prof Dr, Nikolaus Kleindienst, Prof Dr, Franziska Friedmann, PhD, Martin Bohus, Prof Dr, Regina Steil, Prof Dr, Meike Müller-Engelmann, Prof Dr, Matthias F Limberger, MA, Lisa-Marie Hartnagel, PhD, Philip Santangelo, Prof Dr, Kathlen Priebe, Dr rer nat |
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| 245 | 1 | 0 | |a Intrusive memory frequency and related inner tension following dialectical behavior therapy or cognitive processing therapy for posttraumatic stress disorder |b an e-diary study |c Sara E Schmitz, PhD, Ulrich W Ebner-Priemer, Prof Dr, Nikolaus Kleindienst, Prof Dr, Franziska Friedmann, PhD, Martin Bohus, Prof Dr, Regina Steil, Prof Dr, Meike Müller-Engelmann, Prof Dr, Matthias F Limberger, MA, Lisa-Marie Hartnagel, PhD, Philip Santangelo, Prof Dr, Kathlen Priebe, Dr rer nat |
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| 520 | |a Background: Intrusive memories are a core symptom of posttraumatic stress disorder (PTSD), yet their retrospective assessment is prone to biases, making real-time methods such as e-diaries essential. While trauma-focused treatments target intrusive symptoms, their efficacy has not yet been evaluated using real-time assessments. Objective: We aimed to use e-diaries to assess and compare the effects of dialectical behavior therapy for PTSD (DBT-PTSD) and cognitive processing therapy (CPT) on intrusive memories and related inner tension in a large sample of PTSD patients. Methods: In a multicenter randomized controlled trial (RCT; German Clinical Trials registration number: DRKS00005578), 193 women with PTSD related to childhood sexual or physical abuse were randomized to receive either DBT-PTSD or CPT. E-diary assessments were conducted at three time points: before treatment, after six months, and after twelve months of therapy. At each time point, participants reported intrusive memories and related inner tension over five consecutive days using an event-based design. Results: Both intrusive memories and related inner tension decreased significantly over time (intrusions: ß = -.53, P<.001; inner tension: ß = -.15, P<.001). While reductions in intrusion frequency did not differ significantly between treatment groups (ß = .05, P=.45), DBT-PTSD was associated with significantly greater reductions in intrusion-related inner tension compared to CPT (ß = -.16, P<.001). Conclusions: This study provides the first real-time evaluation of trauma-focused PTSD treatments using e-diaries in daily life. Both interventions were associated with reduced intrusion frequency, while DBT-PTSD showed greater reductions in associated emotional distress, potentially reflecting its emphasis on emotion regulation strategies and repeated imaginal exposure. These findings highlight the value of e-diaries for capturing treatment-related symptom change in ecologically valid contexts. Clinical Trial: Participants of this study were recruited as part of a multicenter RCT (German Clinical Trials registration number: DRKS00005578), titled “Treating Psychosocial and Neural Consequences of Childhood Interpersonal Violence in Adults”. | ||
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