title: Prolonged Exposure for Guilt and Shame in a Veteran of Operation Iraqi Freedom.
abstract: Morally injurious events appear capable of producing posttraumatic stress disorder (PTSD), even though they may not involve actual or perceived life-threat or a response of fear, horror, or helplessness. Researchers have questioned whether exposure therapies can address these events. The current report presents evidence of the effectiveness of this treatment approach for addressing posttraumatic symptoms related to a morally injurious event through an illustrative case of an Operation Iraqi Freedom veteran with PTSD characterized by symptoms of guilt and shame. The veteran was successfully treated with nine sessions of prolonged exposure therapy, reporting minimal PTSD symptoms one week post-treatment and at a six-month follow-up assessment. Implications for the treatment of veterans with significant guilt and shame using exposure-based therapies, and with respect to the recent changes to the diagnostic criteria for PTSD, are discussed.
authors.affiliation: Northern Illinois University, Department of Psychology, DeKalb, IL.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Paul
authors.affiliation: Ralph H. Johnson VAMC, Charleston, SC ; Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Charleston, SC.
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Gros
authors.affiliation: Ralph H. Johnson VAMC, Charleston, SC ; Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Charleston, SC.
authors.forename: Martha
authors.initials: M
authors.lastname: Strachan
authors.affiliation: Ralph H. Johnson VAMC, Charleston, SC.
authors.forename: Glenna
authors.initials: G
authors.lastname: Worsham
authors.affiliation: University of Pennsylvania, Department of Psychiatry, Philadelphia, PA.
authors.forename: Edna B
authors.initials: EB
authors.lastname: Foa
authors.affiliation: Ralph H. Johnson VAMC, Charleston, SC ; Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Charleston, SC.
authors.forename: Ron
authors.initials: R
authors.lastname: Acierno
keywords: Operation Iraqi Freedom; PTSD; Prolonged exposure; guilt; moral injury