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Change in Self-compassion, Psychological Inflexibility, and Interpersonal Courage in Intensive PTSD Treatment: A Latent Growth Curve Analysis

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Abstract

Objectives

Despite numerous advances in the understanding of the development and maintenance of posttraumatic stress disorder (PTSD), current research is often narrowly focused on symptom reduction. Despite this, the impact of PTSD also extends into areas such as interpersonal relationships, pursuit of valued activities, and self-acceptance. These processes appear to be especially relevant in chronic/complex PTSD but are rarely represented in controlled trials. As a result, there is a need to expand the focus of PTSD research beyond symptom reduction to include processes of well-being.

Methods

Using a latent growth curve analytical approach, this study examined the impact of change in self-compassion, psychological inflexibility, and interpersonal courage on PTSD symptom reduction, trauma-related shame, quality of life, and valued living for participants in an exposure-based PTSD partial hospitalization program (n = 537; 75% White; 83% female; mean age = 36).

Results

All key processes assessed except for interpersonal courage showed clinically meaningful change over the course of the program. For the PTSD and valued living three-piece spline model slopes, only the three self-compassion slopes were significant predictors (p < .001). The psychological inflexibility slope predicted the quality of life slope (p < .001), while the interpersonal courage slope predicted the trauma-related shame slope (p < .001).

Conclusions

Results supported the importance of broadening the focus of PTSD conceptualization, treatment, and outcome assessment to include processes such as psychological inflexibility, self-compassion, and interpersonal courage.

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Authors and Affiliations

  1. Department of Counselor Education and Counseling Psychology, Marquette University, Schroeder Health and Education Complex, 317, Milwaukee, WI, 53233, USA

    Peter P. Grau, Timothy P. Melchert & Lynne M. Knobloch-Fedders

  2. Vrije Universiteit Amsterdam, Amsterdam, Netherlands

    Mauricio Garnier-Villarreal

  3. Rogers Behavioral Health, West Allis, USA

    Chad T. Wetterneck

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  1. Peter P. Grau
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Contributions

PPG: designed and executed the study, conducted the data analyses, and wrote the paper. TPM: collaborated with the design and writing of the study. MGV: assisted with data analysis and wrote part of the results. LKF: collaborated in the writing and editing of the final manuscript.

CTW: collaborated with study design, execution, and paper editing.

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Correspondence to Peter P. Grau.

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Grau, P.P., Melchert, T.P., Garnier-Villarreal, M. et al. Change in Self-compassion, Psychological Inflexibility, and Interpersonal Courage in Intensive PTSD Treatment: A Latent Growth Curve Analysis. Mindfulness 12, 2983–2996 (2021). https://doi.org/10.1007/s12671-021-01759-6

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