New research investigates the role of guilt and shame on the severity of post-traumatic stress disorder (PTSD) among current and former members of the armed services.
Investigators explain that veterans and military service members have increased risk for post-traumatic stress disorder (PTSD) and consequent problems with health, psychosocial functioning, and quality of life.
In this population and others, shame and guilt have emerged as contributors to PTSD, but there is a considerable need for research that precisely demonstrates how shame and guilt are associated with PTSD.
The new study, published in the British Journal of Clinical Psychology, examined whether trauma-related shame or trauma-related guilt play more of a role in PTSD symptoms.
The study, conducted at the University of Tulsa, included analysis of data collected from an online survey. The survey targeted PTSD symptom severity as well as trauma-related guilt and trauma-related shame among 61 American service personnel and veterans.
The research was led by Dr. Katherine C. Cunningham from the Department of Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, N.C.
Study results showed that both shame and guilt predicted the presence of PTSD, jointly accounting for 46 percent of the variance in its severity. However, the research team also found that trauma-related shame accounted for significantly more of that variance than trauma-related guilt.
In this study, the feeling of guilt was defined as being associated with having done something wrong. For instance, “I didn’t keep my friend safe in combat” or “I killed civilians during the war.”
Shame was defined as a belief that one is intrinsically and irrevocably flawed, for example “I’m a failure” or “I’m a monster.”
In other words, guilt arises from the belief that you have done a bad thing and shame from the belief that you are a bad person.
Cunningham believes that guilt may result in more prosocial behavior, because the underlying attributions are tied to a specific harmful action and not to one’s identity.
“Feeling guilty can motivate an attempt to repair and strengthen social relationships by making amends, while feeling shame can lead people to withdraw from society,” Cunningham said.
Researchers believe the study findings provide additional evidence that shame and guilt should be viewed as distinct emotions with unique roles in PTSD.
Moreover, the results highlight the importance of assessing and addressing trauma-related shame and guilt in PTSD treatment among military populations.
Cunningham and her colleagues suggest that emotion- and compassion-focused techniques may be particularly relevant for addressing trauma-related shame and guilt.