Trauma-related emotions and radical acceptance in dialectical behavior therapy for posttraumatic stress disorder after childhood sexual abuse

Nora Görg (Lead / Corresponding author), Kathlen Priebe, Jan R. Böhnke, Regina Steil, Anne S. Dyer, Nikolaus Kleindienst

    Research output: Contribution to journalArticle

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    Abstract

    Background: Posttraumatic Stress Disorder (PTSD) related to childhood sexual abuse (CSA) is often associated with a wide range of trauma-related aversive emotions such as fear, disgust, sadness, shame, guilt, and anger. Intense experience of aversive emotions in particular has been linked to higher psychopathology in trauma survivors. Most established psychosocial treatments aim to reduce avoidance of trauma-related memories and associated emotions. Interventions based on Dialectical Behavior Therapy (DBT) also foster radical acceptance of the traumatic event.

    Methods: This study compares individual ratings of trauma-related emotions and radical acceptance between the start and the end of DBT for PTSD (DBT-PTSD) related to CSA. We expected a decrease in trauma-related emotions and an increase in acceptance. In addition, we tested whether therapy response according to the Clinician Administered PTSD-Scale (CAPS) for the DSM-IV was associated with changes in trauma-related emotions and acceptance. The data was collected within a randomized controlled trial testing the efficacy of DBT-PTSD, and a subsample of 23 women was included in this secondary data analysis.

    Results: In a multilevel model, shame, guilt, disgust, distress, and fear decreased significantly from the start to the end of the therapy whereas radical acceptance increased. Therapy response measured with the CAPS was associated with change in trauma-related emotions.

    Conclusions: Trauma-related emotions and radical acceptance showed significant changes from the start to the end of DBT-PTSD. Future studies with larger sample sizes and control group designs are needed to test whether these changes are due to the treatment.
    Original languageEnglish
    Article number15
    Pages (from-to)2-12
    Number of pages12
    JournalBorderline Personality Disorder and Emotion Dysregulation
    Volume4
    DOIs
    Publication statusPublished - 13 Jul 2017

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    Behavior Therapy
    Sex Offenses
    Post-Traumatic Stress Disorders
    Emotions
    Wounds and Injuries
    Shame
    Guilt
    Fear
    Therapeutics
    Anger
    Psychopathology
    Diagnostic and Statistical Manual of Mental Disorders
    Sample Size
    Survivors
    Randomized Controlled Trials
    Control Groups

    Keywords

    • Posttraumatic stress disorder
    • Exposure therapy
    • Dialectical behavior therapy

    Cite this

    @article{051655ff8a3c4e3c845b1ce48e8aaea1,
    title = "Trauma-related emotions and radical acceptance in dialectical behavior therapy for posttraumatic stress disorder after childhood sexual abuse",
    abstract = "Background: Posttraumatic Stress Disorder (PTSD) related to childhood sexual abuse (CSA) is often associated with a wide range of trauma-related aversive emotions such as fear, disgust, sadness, shame, guilt, and anger. Intense experience of aversive emotions in particular has been linked to higher psychopathology in trauma survivors. Most established psychosocial treatments aim to reduce avoidance of trauma-related memories and associated emotions. Interventions based on Dialectical Behavior Therapy (DBT) also foster radical acceptance of the traumatic event.Methods: This study compares individual ratings of trauma-related emotions and radical acceptance between the start and the end of DBT for PTSD (DBT-PTSD) related to CSA. We expected a decrease in trauma-related emotions and an increase in acceptance. In addition, we tested whether therapy response according to the Clinician Administered PTSD-Scale (CAPS) for the DSM-IV was associated with changes in trauma-related emotions and acceptance. The data was collected within a randomized controlled trial testing the efficacy of DBT-PTSD, and a subsample of 23 women was included in this secondary data analysis.Results: In a multilevel model, shame, guilt, disgust, distress, and fear decreased significantly from the start to the end of the therapy whereas radical acceptance increased. Therapy response measured with the CAPS was associated with change in trauma-related emotions.Conclusions: Trauma-related emotions and radical acceptance showed significant changes from the start to the end of DBT-PTSD. Future studies with larger sample sizes and control group designs are needed to test whether these changes are due to the treatment.",
    keywords = "Posttraumatic stress disorder, Exposure therapy, Dialectical behavior therapy",
    author = "Nora G{\"o}rg and Kathlen Priebe and B{\"o}hnke, {Jan R.} and Regina Steil and Dyer, {Anne S.} and Nikolaus Kleindienst",
    note = "The RCT was funded by the German Research Foundation (DFG; STE1818/2–1). The sponsor did not have any influence on the study design, data collection, analysis and interpretation nor in the writing of the report or the decision to submit the manuscript.",
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    doi = "10.1186/s40479-017-0065-5",
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    Trauma-related emotions and radical acceptance in dialectical behavior therapy for posttraumatic stress disorder after childhood sexual abuse. / Görg, Nora (Lead / Corresponding author); Priebe, Kathlen; Böhnke, Jan R.; Steil, Regina; Dyer, Anne S.; Kleindienst, Nikolaus.

    In: Borderline Personality Disorder and Emotion Dysregulation, Vol. 4, 15, 13.07.2017, p. 2-12.

    Research output: Contribution to journalArticle

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    T1 - Trauma-related emotions and radical acceptance in dialectical behavior therapy for posttraumatic stress disorder after childhood sexual abuse

    AU - Görg, Nora

    AU - Priebe, Kathlen

    AU - Böhnke, Jan R.

    AU - Steil, Regina

    AU - Dyer, Anne S.

    AU - Kleindienst, Nikolaus

    N1 - The RCT was funded by the German Research Foundation (DFG; STE1818/2–1). The sponsor did not have any influence on the study design, data collection, analysis and interpretation nor in the writing of the report or the decision to submit the manuscript.

    PY - 2017/7/13

    Y1 - 2017/7/13

    N2 - Background: Posttraumatic Stress Disorder (PTSD) related to childhood sexual abuse (CSA) is often associated with a wide range of trauma-related aversive emotions such as fear, disgust, sadness, shame, guilt, and anger. Intense experience of aversive emotions in particular has been linked to higher psychopathology in trauma survivors. Most established psychosocial treatments aim to reduce avoidance of trauma-related memories and associated emotions. Interventions based on Dialectical Behavior Therapy (DBT) also foster radical acceptance of the traumatic event.Methods: This study compares individual ratings of trauma-related emotions and radical acceptance between the start and the end of DBT for PTSD (DBT-PTSD) related to CSA. We expected a decrease in trauma-related emotions and an increase in acceptance. In addition, we tested whether therapy response according to the Clinician Administered PTSD-Scale (CAPS) for the DSM-IV was associated with changes in trauma-related emotions and acceptance. The data was collected within a randomized controlled trial testing the efficacy of DBT-PTSD, and a subsample of 23 women was included in this secondary data analysis.Results: In a multilevel model, shame, guilt, disgust, distress, and fear decreased significantly from the start to the end of the therapy whereas radical acceptance increased. Therapy response measured with the CAPS was associated with change in trauma-related emotions.Conclusions: Trauma-related emotions and radical acceptance showed significant changes from the start to the end of DBT-PTSD. Future studies with larger sample sizes and control group designs are needed to test whether these changes are due to the treatment.

    AB - Background: Posttraumatic Stress Disorder (PTSD) related to childhood sexual abuse (CSA) is often associated with a wide range of trauma-related aversive emotions such as fear, disgust, sadness, shame, guilt, and anger. Intense experience of aversive emotions in particular has been linked to higher psychopathology in trauma survivors. Most established psychosocial treatments aim to reduce avoidance of trauma-related memories and associated emotions. Interventions based on Dialectical Behavior Therapy (DBT) also foster radical acceptance of the traumatic event.Methods: This study compares individual ratings of trauma-related emotions and radical acceptance between the start and the end of DBT for PTSD (DBT-PTSD) related to CSA. We expected a decrease in trauma-related emotions and an increase in acceptance. In addition, we tested whether therapy response according to the Clinician Administered PTSD-Scale (CAPS) for the DSM-IV was associated with changes in trauma-related emotions and acceptance. The data was collected within a randomized controlled trial testing the efficacy of DBT-PTSD, and a subsample of 23 women was included in this secondary data analysis.Results: In a multilevel model, shame, guilt, disgust, distress, and fear decreased significantly from the start to the end of the therapy whereas radical acceptance increased. Therapy response measured with the CAPS was associated with change in trauma-related emotions.Conclusions: Trauma-related emotions and radical acceptance showed significant changes from the start to the end of DBT-PTSD. Future studies with larger sample sizes and control group designs are needed to test whether these changes are due to the treatment.

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    KW - Exposure therapy

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    U2 - 10.1186/s40479-017-0065-5

    DO - 10.1186/s40479-017-0065-5

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