A clinical trial comparing trauma‐informed guilt reduction therapy (TrIGR), a brief intervention for trauma‐related guilt, to supportive care therapy
Introduction Trauma‐related guilt is common, associated with posttraumatic mental health problems, and can persist after posttraumatic stress disorder (PTSD) treatment. We compared the efficacy of two six‐session psychotherapies, Trauma‐Informed Guilt Reduction (TrIGR) and Supportive Care Therapy (S...
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| Veröffentlicht in: | Depression and anxiety 2022-04, Vol.39 (4), p.262-273 |
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| creator | Norman, Sonya B. Capone, Christy Panza, Kaitlyn E. Haller, Moira Davis, Brittany C. Schnurr, Paula P. Shea, M. Tracie Browne, Kendall Norman, Gregory J. Lang, Ariel J. Kline, Alexander C. Golshan, Shahrokh Allard, Carolyn B. Angkaw, Abigail |
| description | Introduction
Trauma‐related guilt is common, associated with posttraumatic mental health problems, and can persist after posttraumatic stress disorder (PTSD) treatment. We compared the efficacy of two six‐session psychotherapies, Trauma‐Informed Guilt Reduction (TrIGR) and Supportive Care Therapy (SCT), for reducing trauma‐related guilt. TrIGR helps patients accurately appraise their role in the trauma and re‐engage in values. In SCT, patients guide session content.
Methods
A total of 184 veterans seeking VA mental health services were enrolled across two sites; 145 veterans (mean age: 39.2 [8.1]; 92.4% male; 84.8% with PTSD) who endorsed guilt related to a traumatic event that occurred during a post 9/11 Iraq or Afghanistan deployment were randomized and assessed at baseline, posttreatment, 3‐ and 6‐month follow‐up.
Results
Linear mixed models using intent‐to‐treat analyses showed guilt decreased in both conditions with a greater decrease for TrIGR (treatment × time, −0.22; F
1, 455.2 = 18.49, p = .001; d = 0.92) than supportive therapy. PTSD and depressive symptoms showed the same pattern. TrIGR had significantly higher likelihood of PTSD treatment response (67% vs. 40%), loss of PTSD diagnosis (50% vs. 14%), and meaningful change in depression (54% vs. 27%) than supportive therapy. Psychological distress and trait shame improved in both conditions. Quality of life did not change.
Conclusions
Targeting guilt appears to be an effective means for reducing posttraumatic symptoms and distress. |
| doi_str_mv | 10.1002/da.23244 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2622656700</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2622656700</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4164-6a85326373fc2e5d7884666648be17c18a90c6578f71181c0effa9601fd626d23</originalsourceid><addsrcrecordid>eNp1kc9qFTEUh4MotlbBJ5CAmwqdmj8zSWZ5qVoLhYLU9ZCbOakpM5PxJNNydz6CW1_PJzH29loQmsVJDnz5TsiPkNecHXPGxPveHgsp6voJ2eeNYJWSbf20nFnLq1qodo-8SOmaMWZaw56TPdkw3Whp9smvFXVDmIKzA80YSnVxnC2G6ar0dhnt7x8_w-QjjtDTqyUMmSL0i8shTjR_A7Tzhh5e4tnpl3dH1NI1BvA0TBnwBqY7qlx-cCEMNu9URzRHmpZ5jpjDDVBnEXbSl-SZt0OCV_f7Afn66ePlyefq_OL07GR1Xrmaq7pS1jRSKKmldwKaXhtTq7JqswauHTe2ZU412njNueGOgfe2VYz7XgnVC3lADrfeGeP3BVLuxpAcDIOdIC6pE0oI1SjNWEHf_odexwWn8rpClalScd08CB3GlBB8N2MYLW46zrq_cXW97e7iKuibe-GyLv_7D9zlU4BqC9yGATaPiroPq63wD-xwoBQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2646636175</pqid></control><display><type>article</type><title>A clinical trial comparing trauma‐informed guilt reduction therapy (TrIGR), a brief intervention for trauma‐related guilt, to supportive care therapy</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>Norman, Sonya B. ; Capone, Christy ; Panza, Kaitlyn E. ; Haller, Moira ; Davis, Brittany C. ; Schnurr, Paula P. ; Shea, M. Tracie ; Browne, Kendall ; Norman, Gregory J. ; Lang, Ariel J. ; Kline, Alexander C. ; Golshan, Shahrokh ; Allard, Carolyn B. ; Angkaw, Abigail</creator><creatorcontrib>Norman, Sonya B. ; Capone, Christy ; Panza, Kaitlyn E. ; Haller, Moira ; Davis, Brittany C. ; Schnurr, Paula P. ; Shea, M. Tracie ; Browne, Kendall ; Norman, Gregory J. ; Lang, Ariel J. ; Kline, Alexander C. ; Golshan, Shahrokh ; Allard, Carolyn B. ; Angkaw, Abigail</creatorcontrib><description>Introduction
Trauma‐related guilt is common, associated with posttraumatic mental health problems, and can persist after posttraumatic stress disorder (PTSD) treatment. We compared the efficacy of two six‐session psychotherapies, Trauma‐Informed Guilt Reduction (TrIGR) and Supportive Care Therapy (SCT), for reducing trauma‐related guilt. TrIGR helps patients accurately appraise their role in the trauma and re‐engage in values. In SCT, patients guide session content.
Methods
A total of 184 veterans seeking VA mental health services were enrolled across two sites; 145 veterans (mean age: 39.2 [8.1]; 92.4% male; 84.8% with PTSD) who endorsed guilt related to a traumatic event that occurred during a post 9/11 Iraq or Afghanistan deployment were randomized and assessed at baseline, posttreatment, 3‐ and 6‐month follow‐up.
Results
Linear mixed models using intent‐to‐treat analyses showed guilt decreased in both conditions with a greater decrease for TrIGR (treatment × time, −0.22; F
1, 455.2 = 18.49, p = .001; d = 0.92) than supportive therapy. PTSD and depressive symptoms showed the same pattern. TrIGR had significantly higher likelihood of PTSD treatment response (67% vs. 40%), loss of PTSD diagnosis (50% vs. 14%), and meaningful change in depression (54% vs. 27%) than supportive therapy. Psychological distress and trait shame improved in both conditions. Quality of life did not change.
Conclusions
Targeting guilt appears to be an effective means for reducing posttraumatic symptoms and distress.</description><identifier>ISSN: 1091-4269</identifier><identifier>EISSN: 1520-6394</identifier><identifier>DOI: 10.1002/da.23244</identifier><identifier>PMID: 35075738</identifier><language>eng</language><publisher>United States: Hindawi Limited</publisher><subject>Adult ; Clinical outcomes ; Clinical trials ; Crisis Intervention ; depression ; Female ; Guilt ; Humans ; Male ; Mental depression ; Mental disorders ; Mental health ; Middle Aged ; Patients ; Post traumatic stress disorder ; Psychotherapy ; PTSD ; Quality of Life ; Stress Disorders, Post-Traumatic - psychology ; Trauma ; treatment ; Veterans - psychology</subject><ispartof>Depression and anxiety, 2022-04, Vol.39 (4), p.262-273</ispartof><rights>Published 2022. This article is a U.S. Government work and is in the public domain in the USA.</rights><rights>2022 Wiley Periodicals LLC</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4164-6a85326373fc2e5d7884666648be17c18a90c6578f71181c0effa9601fd626d23</citedby><cites>FETCH-LOGICAL-c4164-6a85326373fc2e5d7884666648be17c18a90c6578f71181c0effa9601fd626d23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fda.23244$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fda.23244$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35075738$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Norman, Sonya B.</creatorcontrib><creatorcontrib>Capone, Christy</creatorcontrib><creatorcontrib>Panza, Kaitlyn E.</creatorcontrib><creatorcontrib>Haller, Moira</creatorcontrib><creatorcontrib>Davis, Brittany C.</creatorcontrib><creatorcontrib>Schnurr, Paula P.</creatorcontrib><creatorcontrib>Shea, M. Tracie</creatorcontrib><creatorcontrib>Browne, Kendall</creatorcontrib><creatorcontrib>Norman, Gregory J.</creatorcontrib><creatorcontrib>Lang, Ariel J.</creatorcontrib><creatorcontrib>Kline, Alexander C.</creatorcontrib><creatorcontrib>Golshan, Shahrokh</creatorcontrib><creatorcontrib>Allard, Carolyn B.</creatorcontrib><creatorcontrib>Angkaw, Abigail</creatorcontrib><title>A clinical trial comparing trauma‐informed guilt reduction therapy (TrIGR), a brief intervention for trauma‐related guilt, to supportive care therapy</title><title>Depression and anxiety</title><addtitle>Depress Anxiety</addtitle><description>Introduction
Trauma‐related guilt is common, associated with posttraumatic mental health problems, and can persist after posttraumatic stress disorder (PTSD) treatment. We compared the efficacy of two six‐session psychotherapies, Trauma‐Informed Guilt Reduction (TrIGR) and Supportive Care Therapy (SCT), for reducing trauma‐related guilt. TrIGR helps patients accurately appraise their role in the trauma and re‐engage in values. In SCT, patients guide session content.
Methods
A total of 184 veterans seeking VA mental health services were enrolled across two sites; 145 veterans (mean age: 39.2 [8.1]; 92.4% male; 84.8% with PTSD) who endorsed guilt related to a traumatic event that occurred during a post 9/11 Iraq or Afghanistan deployment were randomized and assessed at baseline, posttreatment, 3‐ and 6‐month follow‐up.
Results
Linear mixed models using intent‐to‐treat analyses showed guilt decreased in both conditions with a greater decrease for TrIGR (treatment × time, −0.22; F
1, 455.2 = 18.49, p = .001; d = 0.92) than supportive therapy. PTSD and depressive symptoms showed the same pattern. TrIGR had significantly higher likelihood of PTSD treatment response (67% vs. 40%), loss of PTSD diagnosis (50% vs. 14%), and meaningful change in depression (54% vs. 27%) than supportive therapy. Psychological distress and trait shame improved in both conditions. Quality of life did not change.
Conclusions
Targeting guilt appears to be an effective means for reducing posttraumatic symptoms and distress.</description><subject>Adult</subject><subject>Clinical outcomes</subject><subject>Clinical trials</subject><subject>Crisis Intervention</subject><subject>depression</subject><subject>Female</subject><subject>Guilt</subject><subject>Humans</subject><subject>Male</subject><subject>Mental depression</subject><subject>Mental disorders</subject><subject>Mental health</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Post traumatic stress disorder</subject><subject>Psychotherapy</subject><subject>PTSD</subject><subject>Quality of Life</subject><subject>Stress Disorders, Post-Traumatic - psychology</subject><subject>Trauma</subject><subject>treatment</subject><subject>Veterans - psychology</subject><issn>1091-4269</issn><issn>1520-6394</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc9qFTEUh4MotlbBJ5CAmwqdmj8zSWZ5qVoLhYLU9ZCbOakpM5PxJNNydz6CW1_PJzH29loQmsVJDnz5TsiPkNecHXPGxPveHgsp6voJ2eeNYJWSbf20nFnLq1qodo-8SOmaMWZaw56TPdkw3Whp9smvFXVDmIKzA80YSnVxnC2G6ar0dhnt7x8_w-QjjtDTqyUMmSL0i8shTjR_A7Tzhh5e4tnpl3dH1NI1BvA0TBnwBqY7qlx-cCEMNu9URzRHmpZ5jpjDDVBnEXbSl-SZt0OCV_f7Afn66ePlyefq_OL07GR1Xrmaq7pS1jRSKKmldwKaXhtTq7JqswauHTe2ZU412njNueGOgfe2VYz7XgnVC3lADrfeGeP3BVLuxpAcDIOdIC6pE0oI1SjNWEHf_odexwWn8rpClalScd08CB3GlBB8N2MYLW46zrq_cXW97e7iKuibe-GyLv_7D9zlU4BqC9yGATaPiroPq63wD-xwoBQ</recordid><startdate>202204</startdate><enddate>202204</enddate><creator>Norman, Sonya B.</creator><creator>Capone, Christy</creator><creator>Panza, Kaitlyn E.</creator><creator>Haller, Moira</creator><creator>Davis, Brittany C.</creator><creator>Schnurr, Paula P.</creator><creator>Shea, M. Tracie</creator><creator>Browne, Kendall</creator><creator>Norman, Gregory J.</creator><creator>Lang, Ariel J.</creator><creator>Kline, Alexander C.</creator><creator>Golshan, Shahrokh</creator><creator>Allard, Carolyn B.</creator><creator>Angkaw, Abigail</creator><general>Hindawi Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>202204</creationdate><title>A clinical trial comparing trauma‐informed guilt reduction therapy (TrIGR), a brief intervention for trauma‐related guilt, to supportive care therapy</title><author>Norman, Sonya B. ; Capone, Christy ; Panza, Kaitlyn E. ; Haller, Moira ; Davis, Brittany C. ; Schnurr, Paula P. ; Shea, M. Tracie ; Browne, Kendall ; Norman, Gregory J. ; Lang, Ariel J. ; Kline, Alexander C. ; Golshan, Shahrokh ; Allard, Carolyn B. ; Angkaw, Abigail</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4164-6a85326373fc2e5d7884666648be17c18a90c6578f71181c0effa9601fd626d23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Clinical outcomes</topic><topic>Clinical trials</topic><topic>Crisis Intervention</topic><topic>depression</topic><topic>Female</topic><topic>Guilt</topic><topic>Humans</topic><topic>Male</topic><topic>Mental depression</topic><topic>Mental disorders</topic><topic>Mental health</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Post traumatic stress disorder</topic><topic>Psychotherapy</topic><topic>PTSD</topic><topic>Quality of Life</topic><topic>Stress Disorders, Post-Traumatic - psychology</topic><topic>Trauma</topic><topic>treatment</topic><topic>Veterans - psychology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Norman, Sonya B.</creatorcontrib><creatorcontrib>Capone, Christy</creatorcontrib><creatorcontrib>Panza, Kaitlyn E.</creatorcontrib><creatorcontrib>Haller, Moira</creatorcontrib><creatorcontrib>Davis, Brittany C.</creatorcontrib><creatorcontrib>Schnurr, Paula P.</creatorcontrib><creatorcontrib>Shea, M. Tracie</creatorcontrib><creatorcontrib>Browne, Kendall</creatorcontrib><creatorcontrib>Norman, Gregory J.</creatorcontrib><creatorcontrib>Lang, Ariel J.</creatorcontrib><creatorcontrib>Kline, Alexander C.</creatorcontrib><creatorcontrib>Golshan, Shahrokh</creatorcontrib><creatorcontrib>Allard, Carolyn B.</creatorcontrib><creatorcontrib>Angkaw, Abigail</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Depression and anxiety</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Norman, Sonya B.</au><au>Capone, Christy</au><au>Panza, Kaitlyn E.</au><au>Haller, Moira</au><au>Davis, Brittany C.</au><au>Schnurr, Paula P.</au><au>Shea, M. Tracie</au><au>Browne, Kendall</au><au>Norman, Gregory J.</au><au>Lang, Ariel J.</au><au>Kline, Alexander C.</au><au>Golshan, Shahrokh</au><au>Allard, Carolyn B.</au><au>Angkaw, Abigail</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A clinical trial comparing trauma‐informed guilt reduction therapy (TrIGR), a brief intervention for trauma‐related guilt, to supportive care therapy</atitle><jtitle>Depression and anxiety</jtitle><addtitle>Depress Anxiety</addtitle><date>2022-04</date><risdate>2022</risdate><volume>39</volume><issue>4</issue><spage>262</spage><epage>273</epage><pages>262-273</pages><issn>1091-4269</issn><eissn>1520-6394</eissn><abstract>Introduction
Trauma‐related guilt is common, associated with posttraumatic mental health problems, and can persist after posttraumatic stress disorder (PTSD) treatment. We compared the efficacy of two six‐session psychotherapies, Trauma‐Informed Guilt Reduction (TrIGR) and Supportive Care Therapy (SCT), for reducing trauma‐related guilt. TrIGR helps patients accurately appraise their role in the trauma and re‐engage in values. In SCT, patients guide session content.
Methods
A total of 184 veterans seeking VA mental health services were enrolled across two sites; 145 veterans (mean age: 39.2 [8.1]; 92.4% male; 84.8% with PTSD) who endorsed guilt related to a traumatic event that occurred during a post 9/11 Iraq or Afghanistan deployment were randomized and assessed at baseline, posttreatment, 3‐ and 6‐month follow‐up.
Results
Linear mixed models using intent‐to‐treat analyses showed guilt decreased in both conditions with a greater decrease for TrIGR (treatment × time, −0.22; F
1, 455.2 = 18.49, p = .001; d = 0.92) than supportive therapy. PTSD and depressive symptoms showed the same pattern. TrIGR had significantly higher likelihood of PTSD treatment response (67% vs. 40%), loss of PTSD diagnosis (50% vs. 14%), and meaningful change in depression (54% vs. 27%) than supportive therapy. Psychological distress and trait shame improved in both conditions. Quality of life did not change.
Conclusions
Targeting guilt appears to be an effective means for reducing posttraumatic symptoms and distress.</abstract><cop>United States</cop><pub>Hindawi Limited</pub><pmid>35075738</pmid><doi>10.1002/da.23244</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Depression and anxiety, 2022-04, Vol.39 (4), p.262-273 |
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| source | MEDLINE; Wiley Online Library All Journals |
| subjects | Adult Clinical outcomes Clinical trials Crisis Intervention depression Female Guilt Humans Male Mental depression Mental disorders Mental health Middle Aged Patients Post traumatic stress disorder Psychotherapy PTSD Quality of Life Stress Disorders, Post-Traumatic - psychology Trauma treatment Veterans - psychology |
| title | A clinical trial comparing trauma‐informed guilt reduction therapy (TrIGR), a brief intervention for trauma‐related guilt, to supportive care therapy |
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