Schreiber Corinna, Kümmerle Stella, Müller-Engelmann Meike
Faculty Human Sciences, Department Psychology, Medical School Hamburg, Hamburg, Germany.
Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe-University Frankfurt, Frankfurt, Germany.
Eur J Psychotraumatol. 2025 Dec;16(1):2501823. doi: 10.1080/20008066.2025.2501823. Epub 2025 May 19.
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. 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). 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. Analyses showed significant and large effects of C-METTA on reducing PTSD symptoms (ranging from = 1.12 to = 1.67), feelings of guilt ( = 1.54) and shame ( = 1.26). Childhood trauma, cumulative trauma and PTSD chronicity did not affect treatment effectiveness. 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.
经历过人际暴力的创伤后应激障碍（PTSD）患者易产生与创伤相关的内疚和羞耻感，且治疗反应往往不尽人意。慈悲心疗法（C-METTA）结合了认知技巧和慈心禅修。它在减轻与创伤相关的内疚和羞耻感方面已显示出有前景的效果。我们在一项准实验性的单组前后测试验中，对人际暴力幸存者中那些遭受与创伤相关的内疚和羞耻感的患者，检验了慈悲心疗法的有效性。另一个目标是检验可能与较低治疗反应相关的变量（童年创伤、累积创伤和PTSD慢性化）。我们对25名经历人际暴力后患有PTSD的个体（年龄 = 19 - 61岁，96%为女性）进行了治疗。我们预测慈悲心疗法将显著减轻：（a）PTSD症状（通过临床医生管理的PTSD量表、PTSD症状检查表第5版和创伤后认知量表测量），（b）内疚感（通过与创伤相关的内疚量表测量）以及（c）羞耻感（通过与创伤相关的羞耻量表测量）。为分析治疗效果，我们进行了重复测量多元方差分析。此外，我们通过额外的协方差分析探索性地研究了童年创伤、累积创伤和PTSD慢性化症状对治疗效果的影响。分析表明，慈悲心疗法在减轻PTSD症状（效应值范围为1.12至1.67）、内疚感（效应值 = 1.54）和羞耻感（效应值 = 1.26）方面有显著且较大的效果。童年创伤、累积创伤和PTSD慢性化并未影响治疗效果。我们的研究结果支持了先前关于慈悲心疗法有效性的研究，并为慈悲心疗法减轻人际暴力后PTSD的有效性增添了有前景的证据。有效性与童年创伤、创伤持续时间和PTSD慢性化无关。均值回归应被视为一个混杂因素。我们建议进行更多研究以支持这些结果。慈悲心疗法可能会增加PTSD治疗的多样性，并根据患者的偏好和各自的症状为患者提供更多选择。
