C-METTA reduces PTSD-related guilt and shame following interpersonal violence.

A combination of cognitive techniques and loving-kindness meditation (C-METTA) significantly reduced PTSD symptoms, trauma-related guilt, and trauma-related shame in 25 survivors of interpersonal violence, 96% of whom were women aged 19–61. Effect sizes were large, ranging from d = 1.12 to d = 1.67 for PTSD symptoms, d = 1.54 for guilt, and d = 1.26 for shame. Childhood trauma, cumulative trauma, and chronic PTSD did not influence treatment effectiveness. The authors suggest C-METTA may expand treatment options for PTSD following interpersonal violence, though regression to the mean should be considered as a confounding factor.

Study at a glance

Abstract

Background: PTSD patients who experienced interpersonal violence are susceptible to trauma-related guilt and shame and often show unsatisfactory treatment response. C-METTA combines cognitive techniques and loving-kindness meditation. It has shown promising effects in reducing trauma-related guilt and shame.Objective: We examined the effectiveness of C-METTA within a quasi-experimental one-group pretest-posttest trial focusing on survivors of interpersonal violence, who suffered from trauma-related guilt and shame. An additional objective was to examine variables potentially associated with lower treatment response (childhood trauma, cumulative trauma, and PTSD chronicity).Method: We treated 25 individuals (age = 19-61, 96% women) with PTSD following interpersonal violence. We predicted that C-METTA would significantly reduce (a) PTSD symptoms (measured by the Clinician Administered PTSD Scale, the PTSD Symptom-Checklist Version 5, and the Posttraumatic Cognitions Inventory), (b) feelings of guilt (measured by the Trauma Related Guilt Inventory) and (c) feelings of shame (measured by the Trauma Related Shame Inventory). To analyse treatment effects, we conducted repeated-measures MANOVAs. Further, we investigated the impact of childhood trauma, cumulative trauma and PTSD chronicity symptoms on treatment effectiveness exploratively via additional MANCOVAs.Results: Analyses showed significant and large effects of C-METTA on reducing PTSD symptoms (ranging from d = 1.12 to d = 1.67), feelings of guilt (d = 1.54) and shame (d = 1.26). Childhood trauma, cumulative trauma and PTSD chronicity did not affect treatment effectiveness.Conclusion: Our findings support previous research concerning the effectiveness of C-METTA and add promising evidence for the effectiveness of C-METTA to reduce PTSD following interpersonal violence. Effectiveness was independent of childhood trauma, trauma-duration and PTSD chronicity. Regression to the mean should be considered as a confounding factor. We suggest more research to support the results. C-METTA might increase PTSD treatment diversity and offer patients a greater bandwidth of options according to their preferences and the respective symptomatology.