Does change in trauma-related shame predict change in PTSD symptomatology?

Abstract

Trauma-related shame (TR-shame) is associated with Posttraumatic Stress Disorder (PTSD) symptoms. However, research findings are inconsistent regarding the role of TR-shame in PTSD treatment. The purpose of this study was to examine if change in TR-shame predicted change in PTSD symptoms in treatment. A sample of 462 adults who received PTSD treatment at a Partial Hospitalization Program completed questionnaires measuring TR-shame (i.e., Trauma-Related Shame Inventory; TRSI) and PTSD symptoms (PTSD Checklist for DSM-5; PCL-5). Latent growth curve models were estimated to examine if the rate of change in TRSI predicted the rate of change in PCL-5 by using structural equation modeling. Furthermore, a latent regression model was estimated to predict the intercept and slope of the PCL-5. Model fits for the PCL-5 and the TRSI linear models were acceptable and both linear slopes were significant. On average, PCL-5 scores reduced 22.18 points from admission to discharge, while TRSI scores reduced 21.9 points from admission to discharge. The results of latent curve regression model suggested that the TRSI linear slope and intercept predicted the PCL-5 linear slope and intercept, respectively. Additionally, post-hoc analyses suggested that the variance in PCL-5 factors at discharge that were explained by TRSI intercept and linear slope ranged from 18.6% to 34.9%. The results of this study indicated that the rate of change in TR-shame predicted the rate of change in PTSD symptoms. Given the negative impact of TR-shame on PTSD symptoms, TR-shame should be a target in treatment for PTSD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).