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A randomised controlled pilot study: the effectiveness of narrative exposure therapy with adult survivors of the Sichuan earthquake

Zang, Yinyin; Hunt, Nigel; Cox, Tom


Yinyin Zang

Nigel Hunt

Tom Cox


Background: Post-Traumatic Stress Disorder (PTSD) is a common psychological reaction after large-scale natural
disasters. Given the number of people involved and shortage of resources in any major disaster, brief, pragmatic
and easily trainable interventions are needed. The aim of this study is to evaluate the efficacy of Narrative Exposure
Therapy (NET) as a short-term treatment for PTSD using Chinese earthquake survivors.
Methods: A randomized waiting-list control pilot study was conducted between December 2009 and March 2010,
at the site of the Sichuan earthquake in Beichuan County, China. Adult participants with newly diagnosed Post
Traumatic Stress Disorder (PTSD) were randomly allocated to Narrative Exposure Therapy (NET) or a Waiting-List
(WL) condition. The latter received NET treatment after a two-week waiting period. To compare the effectiveness of
NET in traumatised earthquake survivors, both groups were assessed on PTSD symptoms, general mental health,
anxiety and depression, social support, coping style and posttraumatic change before and after treatment and two
months post treatment.
Results: Adult participants (n=22) were randomly allocated to receive NET (n=11) or WL (n=11). Twenty two
participants (11 in NET group, 11 in WL) were included in the analysis of primary outcomes. Compared with WL,
NET showed significant reductions in PTSD symptoms, anxiety and depression, general mental stress and increased
posttraumatic growth. The WL group later showed similar improvements after treatment. These changes remained
stable for a two-month follow-up. Measures of social support and coping showed no stable effects.
Conclusions: NET is effective in treating post-earthquake traumatic symptoms in adult Chinese earthquake
survivors. The findings help advance current knowledge in the management of PTSD after natural disasters and
inform future research. Larger sample sizes are needed to extend the present findings.
Trial registration: Chinese Clinical Trial Registry ChiCTR-TRC-12002473
Keywords: Earthquake, Exposure, Disaster, Narrative, PTSD, Therapy

Journal Article Type Article
Publication Date Jan 31, 2013
Journal BMC Psychiatry
Electronic ISSN 1471-244X
Publisher Humana Press
Peer Reviewed Peer Reviewed
Volume 13
Article Number 41
Institution Citation Zang, Y., Hunt, N., & Cox, T. (2013). A randomised controlled pilot study: the effectiveness of narrative exposure therapy with adult survivors of the Sichuan earthquake. BMC Psychiatry, 13, doi:10.1186/1471-244X-13-41
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