Anger and Guilt in Treatment for Chronic Posttraumatic Stress Disorder
Anger and guilt are associated with PTSD and depression (e.g., Novaco & Chemtob, 2002; Henning & Freuh, 1997). Yet, little work has investigated how anger, guilt, PTSD and depression relate in baseline psychopathology, treatment engagement, and outcome. The present study utilized baseline, in-session, and posttreatment data from two hundred trauma survivors with PTSD. The first aim examined the association between PTSD and anger and guilt at baseline and found depression to mediate the relationship between specific PTSD symptoms and guilt. The second aim investigated whether anger and guilt were negatively correlated with engagement. Lastly, aim three examined anger and guilt as predictors of worse treatment outcome and engagement as a mediator of treatment outcome. Results indicated that anger and guilt did not hinder emotional engagement and did not impede effective PTSD treatment. Anger and guilt decreased as a result of PTSD treatment implying tolerability and broad applicability of prolonged exposure.
Psychology, PTSD treatment, anger, guilt, emotional engagement
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Case Western Reserve University School of Graduate Studies