Comparing Exposure ‐ and Coping Skills–Based Treatments on Trauma‐Related Guilt in Veterans With Co‐Occurring Alcohol Use and Posttraumatic Stress Disorders

AbstractPosttraumatic stress disorder (PTSD) and substance use disorders (SUD) commonly co ‐occur, and this comorbidity (PTSD–SUD) is associated with more severe symptoms and functional impairment than either disorder alone. Growing evidence indicates that trauma‐related guilt, typically concerning negative appraisals of one's actions or inaction during a traumatic event, is associa ted with PTSD, depression, suicidality, and, possibly, substance use. The present study examined whether integrated treatment for PTSD–SUD was effective in reducing trauma‐related guilt as measured by the Trauma‐Related Guilt Inventory. Data were drawn from a randomized clinical trial comparin g the effectiveness of two integrated therapies on treatment outcomes in a sample of U.S. veterans (N = 119) with comorbid PTSD and SUD. Participants were randomized to receive either Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE;n = 63) or Seeking Safety (SS;n = 56). The results indicated that global guilt decreased over time for the whole sample. However, there was a significant Treatment × Time interaction, such that participants in the COPE condition reported lower rates of global guilt,d = 0.940, over time compared to those in the SS condition,d = .498. To our knowledge, this was the first study to examine the effects of integrated PTSD –SUD treatment on trauma‐related guilt. The findings highlight that exposure‐based, trauma‐focused treatme...
Source: Journal of Traumatic Stress - Category: Psychiatry & Psychology Authors: Tags: Brief Report Source Type: research