Guilt about surviving a traumatic event is thought to be an associated feature of posttraumatic stress disorder (PTSD). Shame is an emotion closely related to guilt but is a distinct affective state. Little is known regarding the role of shame in PTSD and there are no studies of PTSD where shame and guilt are examined simultaneously. We used a measure of shame- and guilt-proneness in 107 community residing former prisoner of war veterans all of whom had been exposed to trauma. The measure of shame-proneness was positively correlated with PTSD symptom severity whereas guilt-proneness was not. This study provides the first empirical data regarding a possible role for shame in PTSD and may have important therapeutic and theoretical implications.

The ongoing wars in Afghanistan (Operation Enduring Freedom or OEF) and Iraq (Operation Iraqi Freedom or OIF) make the development and application of effective postdeployment mental health treatment programs a high priority. There has been some concern that existing treatment programs for combat-related posttraumatic stress disorder (PTSD) may not fit well with OEF/OIF veterans confronted with acute mental health difficulties while reestablishing community, familial, and occupational connections after their deployment. This study utilized data gathered from a large outpatient Veterans Affairs Medical Center PTSD treatment clinic to examine differences in initial treatment presentation and treatment adherence (attendance and dropout) between a group of Vietnam era veterans (n ϭ 54) and a group of OEF/OIF veterans (n ϭ 106). OEF/OIF veterans reported lower levels of symptom distress on questionnaires assessing posttraumatic reexperiencing, avoidance, dissociation, and arousal symptoms but similar levels of anger and acting out behaviors and higher levels of alcohol problems. OEF/OIF veterans had significantly lower rates of session attendance and higher rates of treatment dropout than Vietnam veterans, and this difference was not accounted for by differences in treatment presentation.

Military personnel commonly experience post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI), both of which are associated with premature mortality. The present study examined two factors that may play a role in premature mortality--impulsivity and risk-taking behaviors--in a sample of 234 veterans screening positive for PTSD, mTBI, PTSD + mTBI, and controls. Analyses of variance demonstrated that veterans with PTSD, regardless of mTBI status, reported engaging in more frequent risky behaviors and reported a greater tendency to engage in impulsive behaviors when in a negative affective state. They also reported more premilitary delinquent behaviors and more suicide-related behaviors than controls. The present study highlights associations between impulsivity, risk-taking behaviors, and PTSD, and suggests continuity across the lifespan in terms of a predisposition to engage in impulsive and/or risky behaviors. Thorough evaluation of impulsivity and potentially risky behaviors is important in clinical settings to guide interventions and reduce the mortality and public health impact of high-risk behaviors in veterans.