title: Trauma-related shame and guilt as time-varying predictors of posttraumatic stress disorder symptoms during imagery exposure and imagery rescripting--A randomized controlled trial.
abstract: OBJECTIVE
  The specific aims of this study are to examine trauma-related shame and guilt as time-varying predictors of symptoms of posttraumatic stress disorder (PTSD).
  
  
  METHODS
  Sixty-five patients were included in the statistical analyses and the multilevel modeling analyses supported three major findings.
  
  
  RESULTS
  (i) Patients with a higher level of shame and guilt at the start of treatment displayed a higher level of PTSD symptoms over the course of treatment compared to other patients. (ii) Time-specific change in shame and guilt predicted the level of PTSD symptoms 3 days later from session to session during treatment. (iii) No significant differences were evident between prolonged exposure (PE) and modified PE to include imagery rescripting in the within-person process of change in PTSD symptoms from session to session during therapy.
  
  
  CONCLUSIONS
  This trial reports the first evidence that within-person change in shame and guilt predicts change in PTSD symptoms from session to session during treatment.
authors.affiliation: a Research Institute, Modum Bad , Vikersund , Norway.
authors.forename: Tuva
authors.initials: T
authors.lastname: Øktedalen
authors.forename: Asle
authors.initials: A
authors.lastname: Hoffart
authors.forename: Tomas Formo
authors.initials: TF
authors.lastname: Langkaas
mesh_terms: D000328:Adult; D005260:Female; D006167:Guilt; D006801:Humans; D019018:Imagery, Psychotherapy / Q000379:methods*; D007171:Implosive Therapy / Q000379:methods; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011379:Prognosis; D012752:Shame; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology* / Q000628:therapy*
keywords: guilt; shame; trauma; treatment of PTSD; within-person effects