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Neurobiological and psychometric markers of the efficacy of cognitive behavioral therapy in post-traumatic stress disorder with dissociative symptoms: a case report

INTRODUCTION: Post-traumatic stress disorder (PTSD) has been associated with dysregulation of many psychophysiological parameters and may present comorbidity with different psychopathologies, including dissociation, potentially affecting treatment outcome. The aim of this study was to evaluate the effects of cognitive behavioral therapy in a patient with PTSD and dissociative symptoms based on psychophysiological and psychometric measures at different time points throughout the course of treatment. CASE DESCRIPTION: Our patient is a 38-year old man diagnosed with PTSD, major depression, and dissociative symptoms, resistant to pharmacotherapy. Psychological treatment lasted for 4 months and consisted of one weekly therapy session and three weekly coaching sessions. Physiological (heart rate, vagal tone, sympathovagal balance, and cortisol) and psychometric measures (negative and positive affect, resilience, and post-traumatic stress, depression, anxiety, and dissociative symptoms) were obtained before, during (once a month) and after treatment. COMMENTS: Results showed a decrease in sympathovagal balance and an increase in heart rate, vagal tone and cortisol levels during the course of treatment. Treatment also lead to a decrease in negative affect and in post-traumatic stress, depression, anxiety, and dissociation symptoms, as well as to an increase in resilience, social support and positive affect scores. These results suggest that cognitive behavioral therapy is an effective treatment for PTSD patients with dissociative symptoms. Moreover, the treatment seems to be able to normalize PTSD-related physiological parameters in the neuroendocrine and autonomic nervous systems.

Post-traumatic stress disorders; psychophysiology; dissociative disorders; psychometrics

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