Publication Date


Document Type


First Advisor

Orcutt, Holly K.

Degree Name

Ph.D. (Doctor of Philosophy)

Legacy Department

Department of Psychology


Trauma exposure is common, with a 90% lifetime endorsement rate in adults in the United States and a majority of first year students reporting exposure to trauma prior to college. A minority of individuals go on to develop PTSD, with higher rates on college campuses (9-12.4%) than lifetime estimates (7%). Existing evidence-based practices for PTSD have demonstrated efficacy in reducing PTSD symptoms (PTSS), but critiques of evidence-based psychotherapies (EBPs) for PTSD include high levels of drop-out and barriers to access. Written exposure therapy (WET) is a brief promising intervention for PTSS with a growing literature of evidence suggesting efficacy with smaller dropout rates and long-term treatment gains. There is little known about the mechanisms of action in WET, nor the efficacy of the protocol alone (i.e., studies done outside of the supervision of the treatment founders). The current study sought to extend the scope of inquiry on WET through examining efficacy and possible mechanisms of change in WET compared to the protocol WET was derived from (expressive writing; EW). Sample included non-treatment-seeking trauma-exposed undergraduates with elevated PTSS. Results suggested both WET and EW were associated with decreases in PTSS and depression symptoms. Contrary to expectations, no group differences in outcomes were detected. Differences between WET and EW in proposed mechanisms emerged, specifically evidence of extinction processes occurring in WET alone. Further, both emotion regulation and posttraumatic cognitions demonstrated a dose-response relationship with changes in PTSS, but temporal precedence of proposed mechanisms could not be established due to limitations in statistical approach. Findings are interpreted in context with recent investigations into mechanisms of WET, adding to the call for more innovation in proposed change agents, as well greater examination of process-based metrics of interventions for posttraumatic recovery.


174 pages




Northern Illinois University

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