Substantial symptom changes in naturalistic recovery from aversive events

Objective: Researchers have recommended examining trajectories of recovery from aversive events, including sudden gains and spikes. We examined rates, attributions for, and outcomes associated with substantial symptom improvements and brief exacerbations after aversive events. Method: Sixty-three women completed questionnaire measures of mood, depression, and posttraumatic stress disorder symptoms. They used a Life History Calendar (LHC) to draw the trajectory of symptom levels from the event to the present, and were interviewed regarding the course of their symptoms. Based on the LHC and interview, we coded whether each participant experienced substantial improvements and/or brief exacerbations and reasons for them. Results: Participants frequently experienced substantial improvements and brief exacerbations, most of which they attributed to external events. Substantial improvements-but not substantial brief exacerbations-were associated with significantly lower symptom levels. Conclusion: Substantial improvements are similar to sudden gains in therapy samples. Substantial improvements in avoidance and mood have positive, bidirectional effects on each other.