title: Mid-Treatment Reduction in Trauma-Related Guilt Predicts PTSD and Functioning Following Cognitive Trauma Therapy for Survivors of Intimate Partner Violence.
abstract: Intimate partner violence (IPV) results in severe and chronic posttraumatic psychological symptoms, maladaptive trauma-related guilt (TRG) and functional impairment for many women. Cognitive Trauma Therapy (CTT) was developed to specifically address empirically identified contributors of distress and functioning difficulties specific to IPV and has been found to be efficacious in treating posttraumatic stress disorder (PTSD) and reducing TRG. The primary aim of this study was to investigate to what extent reductions in TRG contribute to improvements in PTSD and functioning, given evidence of the important role that TRG plays in posttraumatic distress in IPV survivors and the emphasis placed on TRG in CTT. Twenty women with IPV-related chronic and functionally impairing posttraumatic distress were recruited from the community and completed CTT as part of a larger neurobiological study of PTSD. Women experienced statistically and clinically significant improvements in functioning as well as expected reductions in PTSD and TRG with large effect sizes at post-treatment, and improvements were maintained at 3-month follow-up, with no participant meeting full PTSD criteria. Pre- to mid-treatment reductions in TRG predicted post-treatment PTSD and functioning outcomes. These findings support the efficacy of CTT and provide preliminary evidence for the importance of addressing TRG. Dismantling research is indicated to identify the active ingredient(s) of this multi-module treatment.
authors.affiliation: 1 VA San Diego Healthcare System, CA, USA.|2 University of California, San Diego, CA, USA.|3 Center of Excellence for Stress and Mental Health, VA, USA.
authors.forename: Carolyn B
authors.initials: CB
authors.lastname: Allard
authors.affiliation: 1 VA San Diego Healthcare System, CA, USA.|2 University of California, San Diego, CA, USA.|3 Center of Excellence for Stress and Mental Health, VA, USA.|4 National Center for PTSD, VA, USA.
authors.forename: Sonya B
authors.initials: SB
authors.lastname: Norman
authors.affiliation: 2 University of California, San Diego, CA, USA.|3 Center of Excellence for Stress and Mental Health, VA, USA.|5 Alliant International University, San Diego, CA, USA.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Thorp
authors.affiliation: 6 VA Puget Sound Healthcare System, Seattle, WA, USA.|7 University of Washington, Seattle, WA, USA.|8 Center of Excellence in Substance Abuse Treatment and Education, VA, USA.
authors.forename: Kendall C
authors.initials: KC
authors.lastname: Browne
authors.affiliation: 1 VA San Diego Healthcare System, CA, USA.|2 University of California, San Diego, CA, USA.
authors.forename: Murray B
authors.initials: MB
authors.lastname: Stein
mesh_terms: D000328:Adult; D003071:Cognition; D015928:Cognitive Behavioral Therapy; D005260:Female; D006167:Guilt; D006801:Humans; D000066511:Intimate Partner Violence / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy; D017741:Survivors / Q000523:psychology; D055815:Young Adult
keywords: PTSD; battered women; domestic violence; intervention/treatment; intimate partner violence; treatment