Shame, guilt, and posttraumatic stress disorder in adult survivors of childhood sexual abuse at risk for human immunodeficiency virus: outcomes of a randomized clinical trial of group psychotherapy treatment.
This study evaluated the effectiveness of group psychotherapy in reducing levels of shame and guilt in adult survivors of childhood sexual abuse at risk for HIV, and whether such reductions would mediate the effects of treatment on posttraumatic stress disorder (PTSD) symptoms. One hundred sixty-six women were randomized into 3 conditions: a trauma-focused group, a present-focused group, and a waitlist group. Women received 6 months of treatment and were assessed at pretreatment (T1), immediately posttreatment (T2), and 6 months posttreatment (T3). Both treatment conditions resulted in reduced shame and guilt. The treatment effect on PTSD symptoms was mediated by changes in shame, but it was not associated with changes in guilt. These findings suggest that, when treating childhood sexual abuse survivors' PTSD, it is important to address the negative self-appraisals, such as shame, that commonly accompany such symptoms.
Ginzburg
Karni
K
Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv 69978, Israel. karnig@post.tau.ac.il
Butler
Lisa D
LD
Giese-Davis
Janine
J
Cavanaugh
Courtenay E
CE
Neri
Eric
E
Koopman
Cheryl
C
Classen
Catherine C
CC
Spiegel
David
D
D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D002648:Child; D002650:Child Abuse, Sexual / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006167:Guilt; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D011615:Psychotherapy, Group / Q000379:methods*; D012107:Research Design; D012307:Risk Factors; D012752:Shame; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome; D014850:Waiting Lists