Changes in Trauma-related Emotions Following Treatment with Dialectical Behavior Therapy for Posttraumatic Stress Disorder after Childhood Abuse

TY - JOUR

T1 - Changes in Trauma-related Emotions Following Treatment with Dialectical Behavior Therapy for Posttraumatic Stress Disorder after Childhood Abuse

AU - Görga, Nora

AU - Boehnke, Jan

AU - Priebe, Kathlen

AU - Rausch, Sophie

AU - Wekenmann, Stefanie

AU - Ludäscher, Petra

AU - Bohus, Martin

AU - Kleindienst, Nikolaus

N1 - © 2019 International Society for Traumatic Stress Studies.

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Dialectical behavior therapy for posttraumatic stress disorder (DBT-PTSD) is a trauma-focused therapy shown to reduce core PTSD symptoms, such as intrusions, hyperarousal, and avoidance. Preliminary data indicate effects on elevated trauma-related emotions (e.g., guilt and shame) and possibly radical acceptance of the traumatic event. However, it is unclear if improvements in these variables are significant after controlling for changes in core PTSD symptoms and to what extent nonclinical levels are obtained. In the current study, 42 individuals who met criteria for PTSD after childhood abuse and were participating in a 3-month residential DBT-PTSD program were evaluated at the start of the exposure phase of DBT-PTSD and the end of treatment; a nonclinical sample with a history of childhood abuse was the reference group. Multivariate analyses of variance and multivariate analyses of covariance controlling for change in core PTSD symptoms were used to evaluate changes in several elevated trauma-related emotions (fear, anger, guilt, shame, disgust, sadness, and helplessness) and in radical acceptance. In a repeated measures multivariate analyses of variance, both elevated trauma-related emotions and radical acceptance significantly improved during DBT-PTSD, λ = 0.34, p <.001; η 2 =.56; t(40) = −5.66, p <.001, SMD = 0.88, even after controlling for changes in PTSD symptoms, λ = 0.35, p <.001, η 2 =.65; Λ = 0.86, p =.018, η 2 =.14, respectively. Posttreatment, 31.0% (for acceptance) to 76.2% (for guilt) of participants showed nonclinical levels of the investigated outcomes, suggesting that both trauma-related emotions and radical acceptance changed after the 3-month residential DBT-PTSD program.

AB - Dialectical behavior therapy for posttraumatic stress disorder (DBT-PTSD) is a trauma-focused therapy shown to reduce core PTSD symptoms, such as intrusions, hyperarousal, and avoidance. Preliminary data indicate effects on elevated trauma-related emotions (e.g., guilt and shame) and possibly radical acceptance of the traumatic event. However, it is unclear if improvements in these variables are significant after controlling for changes in core PTSD symptoms and to what extent nonclinical levels are obtained. In the current study, 42 individuals who met criteria for PTSD after childhood abuse and were participating in a 3-month residential DBT-PTSD program were evaluated at the start of the exposure phase of DBT-PTSD and the end of treatment; a nonclinical sample with a history of childhood abuse was the reference group. Multivariate analyses of variance and multivariate analyses of covariance controlling for change in core PTSD symptoms were used to evaluate changes in several elevated trauma-related emotions (fear, anger, guilt, shame, disgust, sadness, and helplessness) and in radical acceptance. In a repeated measures multivariate analyses of variance, both elevated trauma-related emotions and radical acceptance significantly improved during DBT-PTSD, λ = 0.34, p <.001; η 2 =.56; t(40) = −5.66, p <.001, SMD = 0.88, even after controlling for changes in PTSD symptoms, λ = 0.35, p <.001, η 2 =.65; Λ = 0.86, p =.018, η 2 =.14, respectively. Posttreatment, 31.0% (for acceptance) to 76.2% (for guilt) of participants showed nonclinical levels of the investigated outcomes, suggesting that both trauma-related emotions and radical acceptance changed after the 3-month residential DBT-PTSD program.

UR - https://www.scopus.com/pages/publications/85071841446

U2 - 10.1002/jts.22440

DO - 10.1002/jts.22440

M3 - Article

C2 - 31476252

SN - 0894-9867

VL - 32

SP - 764

EP - 773

JO - Journal of Traumatic Stress

JF - Journal of Traumatic Stress

IS - 5

ER -