Self-stigma in PTSD: Prevalence and correlates

Self-stigma is the internalization of negative societal stereotypes about those with mental illnesses. While self-stigma has been carefully characterized in severe mental disorders, like schizophrenia, the field has yet to examine the prevalence and correlates of self-stigma in post-traumatic stress disorder (PTSD). Thus, we assessed self-stigma in veterans diagnosed with PTSD and compared with veterans with schizophrenia. We further examined associations between PTSD, depressive symptoms and self-stigma in the PTSD sample. Data came from two larger studies of people with PTSD (n = 46) and schizophrenia-spectrum disorders (n = 82). All participants completed the Internalized Stigma of Mental Illness Scale (ISMIS). Results revealed that people with schizophrenia report more experiences of discrimination as a result of stigma than do those with PTSD, but these diagnostic groups did not differ for other subscales. In the PTSD group, feelings of alienation positively correlated with PTSD and depressive symptoms; other subscales positively correlated with depressive symptoms only. Taken together, results suggest a significant level of self-stigma exists among veterans with PTSD, and that self-stigma has an effect on PTSD and commonly comorbid symptoms, like depression. Future work should investigate whether current self-stigma interventions for other groups could be applicable for those with PTSD

Testing Adaptations of Cognitive-Behavioral Conjoint Therapy for PTSD: A Randomized Controlled Pilot Study with Veterans

Iraq and Afghanistan Veterans with posttraumatic stress disorder (PTSD) have well-documented relationship problems and many wish to include their intimate partners in treatment. This pilot study randomly assigned 46 couples (Veterans with clinician-administered PTSD scale confirmed PTSD diagnosis and their intimate partners) to one of two groups. The treatment group received a modified mindfulness-based version of cognitive-behavioral conjoint therapy for PTSD (CBCT; Monson & Fredman, 2012) that included all three phases of the mindfulness-based cognitive behavioral conjoint therapy (MB-CBCT). The control group received a modified version of CBCT that included communication skills training from Phases 1 and 2 of CBCT (CBCT-CS) without PTSD-specific content. Modified CBCT Phases 1 and 2 content was delivered to both groups during weekend retreats in multicouple group sessions. The postretreat protocol for MB-CBCT included nine individual couple sessions: a transition session following the retreat, and CBCT Phase 3. For CBCT-CS, two additional monthly multicouple group sessions reviewed communication skills. No statistically significant pre- to posttreatment differences were detected for primary outcomes between groups: Clinician-Administered PTSD Scale for Veterans (mean change difference, −1.4, 95% CI [−16.0 to 13.2]); Dyadic Adjustment Scale for Veterans (mean change difference, −1.0, 95% CI [−13.2 to 11.2]); and Dyadic Adjustment Scale for Partners (mean change difference, −0.4, 95% CI [−8.9 to 8.1]). However, within group pre- to posttreatment effect sizes were medium to large for both MB-CBCT and CBCT-CS on all three primary outcomes. Findings suggest that Veterans returning from recent conflicts and their partners may benefit from both modifications of CBCT