Veterans who focus on sexual assault trauma show slower between-session habituation and symptom reduction during prolonged exposure treatment for posttraumatic stress disorder.

Objective: Prolonged exposure (PE) is an effective treatment for posttraumatic stress disorder (PTSD), but veterans with sexual assault (SA) trauma often discontinue it prematurely. Elevated dropout rates may be due to SA triggering more intense and complex emotions that are more difficult to habituate during imaginal exposures; SA during PE has yet to be examined as a moderator of distress habituation or symptom reduction.

Method: Participants were = 65 veterans ( = 12 SA treatment focus; = 10 SA history but not treatment focus; = 43 no SA history) enrolled in a clinical trial of a preparatory sleep intervention followed by PE.