A randomized controlled trial of cognitive-behavior therapy for Cambodian refugees with treatment-resistant PTSD and panic attacks: a cross-over design

J Trauma Stress. 2005 Dec;18(6):617-29. doi: 10.1002/jts.20070.


We examined the therapeutic efficacy of a culturally adapted cognitive-behavior therapy for Cambodian refugees with treatment-resistant posttraumatic stress disorder (PTSD) and comordid panic attacks. We used a cross-over design, with 20 patients in the initial treatment (IT) condition and 20 in delayed treatment (DT). Repeated measures MANOVA, Group & times; Time ANOVAs, and planned contrasts indicated significantly greater improvement in the IT condition, with large effect sizes (Cohen's d) for all outcome measures: Anxiety Sensitivity Index (d = 3.78), Clinician-Administered PTSD Scale (d = 2.17), and Symptom Checklist 90-R subscales (d = 2.77). Likewise, the severity of (culturally related) neck-focused and orthostasis-cued panic attacks, including flashbacks associated with these subtypes, improved across treatment.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Cambodia / ethnology
  • Cognitive Behavioral Therapy / methods*
  • Conditioning, Psychological
  • Cross-Over Studies
  • Female
  • Humans
  • Hypotension, Orthostatic / psychology
  • Male
  • Middle Aged
  • Models, Psychological
  • Neck
  • Panic Disorder / ethnology
  • Panic Disorder / physiopathology
  • Panic Disorder / psychology
  • Panic Disorder / therapy*
  • Refugees / psychology*
  • Stress Disorders, Post-Traumatic / ethnology
  • Stress Disorders, Post-Traumatic / psychology
  • Stress Disorders, Post-Traumatic / therapy*
  • United States