Resolution of trauma-related guilt following treatment of PTSD in female rape victims: A result of cognitive processing therapy targeting comorbid depression?

Abstract

Background and methods-Although Resick et al. (2002) [Resick, P.A., Nishith, P., Weaver, T.L., Astin, M.C., Feuer, C.A., 2002. A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. J. Consult. Clin. Psychol. 70,[867][868][869][870][871][872][873][874][875][876][877][878][879] reported comparable results for treating raperelated posttraumatic stress disorder (PTSD) using either cognitive-processing therapy (CPT) or prolonged exposure (PE), there was some suggestion that CPT resulted in better outcomes than PE for certain aspects of trauma-related guilt. The present study revisited these findings to examine whether this effect was a function of improvement in a subset of participants with both PTSD and major depressive disorder (MDD).Results-Results indicated that CPT was just as effective in treating 'pure' PTSD and PTSD with comorbid MDD in terms of guilt. Clinical significance testing underscored that CPT was more effective in reducing certain trauma-related guilt cognitions than PE.Limitations-Findings cannot be generalized to men, and only one measure of guilt was used.Conclusions-The observed superiority of CPT over PE for treating certain guilt cognitions was not due to participant comorbidity. Further research is recommended to untangle the relationship between guilt, depression and differential response to treatment in PTSD following sexual assault trauma.

Moral Emotions and Moral Behavior

“…Trauma-related guilt cognitions, such as false beliefs about responsibility or pre-outcome knowledge, are reliably associated with symptoms of depression among diverse samples of trauma survivors (Blacher 2000;Kubany et al 1995Kubany et al , 2004Lee et al 2001). Moreover, cognitive processing therapy and prolonged exposure interventions appear to be effective at reducing trauma-related guilt cognitions (Nishith et al 2005, Resick et al 2002.…”

Posttraumatic stress disorder: Anxiety or traumatic stress disorder?

“…Studies have found guilt to be strongly associated with PTSD among combat veterans, battered women, and rape victims (Beckham, Feldman, & Kirby, 1998;Henning & Frueh, 1997;Kubany et al, 1995Kubany et al, , 1996Nishith, Nixon, & Resick, 2005). Leskela, Keipering, and Thuras (2002) found former prisoners of war with PTSD were more likely to have shame, but not guilt.…”

Stabilizing Group Treatment for Complex Posttraumatic Stress Disorder Related to Child Abuse Based on Psychoeducation and Cognitive Behavioural Therapy: A Multisite Randomized Controlled Trial

“…During the last few years, a growing number of studies [15,22,24,25,26] have indicated that cognitive behavioural therapy elements may be effective in the treatment of child abuse-related PTSD, especially in reducing feelings of guilt and shame, which are complex PTSD symptoms. The guideline of the International Society for Traumatic Stress Studies [12] stated that patients with an inability to tolerate strong affects should initially focus on ‘stabilization’, so-called phase-based treatment [27].…”