A relative weights comparison of trauma‐related shame and guilt as predictors of<scp>DSM</scp>‐5 posttraumatic stress disorder symptom severity among<scp>US</scp>veterans and military members

Cunningham, Katherine C.; Davis, Joanne L.; Wilson, Sarah M.; Resick, Patricia A.

doi:10.1111/bjc.12163

Cited by 38 publications

(38 citation statements)

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“…It might be a subjective choice of researchers to study the negative religious coping mostly with reference to military trauma. However, it can also be claimed that the struggle with religion is more interesting in the case of this type of trauma that is commonly associated with guilt (Cunningham et al, ). The results concerning sexual trauma are mixed as various dimensions of religiosity were shown to predict the greater severity of symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…For instance, stigmatization and self‐blame are ubiquitous factors that impede recovery in survivors of sexual trauma (i.e., Kennedy & Prock, ); conservative religiosity may potentially (the evidence for this will be reviewed in this paper) exasperate this process. Similarly, guilt is associated with greater severity of PTSD symptoms following the military trauma (Cunningham, Davis, Wilson, & Resick, )—The potential exasperating role of religiosity will also be explored.…”

Section: Introductionmentioning

confidence: 99%

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Religiosity and the psychological outcomes of trauma: A systematic review of quantitative studies

Kucharska

2019

J Clin Psychol

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Objective This is a broad review examining the relationships between religiosity and the psychological outcomes of trauma. Previous studies showed that some constructs of religiosity are associated with lower severity of symptoms of mental disorders, whereas others, for instance, negative religious coping, predict deteriorated mental health. Method A systematic review of peer‐reviewed quantitative studies was conducted to examine the patterns of relationships between religiosity and psychological outcomes of trauma, potential causal relationships, and specific effect of religiosity on the outcomes on trauma. Results A total of 79 quantitative studies were included. The majority focused on military trauma or various types of traumatic exposure in the general population. Most of the studies employed a cross‐sectional design. Conclusions The associations between religiosity and psychological outcomes of trauma depend on the concept of religion used in a study, type of trauma. There is not enough evidence to support the causal effect of religiosity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Religiosity and the psychological outcomes of trauma: A systematic review of quantitative studies

Kucharska

2019

J Clin Psychol

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“…Additionally, shame-proneness impaired empathy, which may result in various interpersonal difficulties [7]. In contrast to shame, guilt seems to be a relatively benign emotion when experienced alone, but becomes maladaptive when being excessive, ruminative, and fused with shame [8,9]. Taken together, the above-outlined negative health outcomes of shame highlight the importance of further research on guilt and shame in the field of public health (see also [10,11]).…”

Section: Introductionmentioning

confidence: 99%

A Psychometric Evaluation of the Guilt and Shame Experience Scale (GSES) on a Representative Adolescent Sample: A Low Differentiation between Guilt and Shame

Maliňáková

Fürstová

Kalman

et al. 2020

IJERPH

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The Guilt and Shame Experience Scale (GSES) is a new, brief self-report instrument for assessing experiences of guilt and shame. It includes two distinct scales: feelings of shame and feelings of guilt. The present report focuses on results from a final validation study using a nationally representative sample of 7899 adolescents (M age = 14.5 ± 1.1 years, 50.7% boys) who participated in the 2014 Health Behavior in School-aged Children study. For factor analysis, the dataset was divided into two groups. One group (n = 3950) was used for the Exploratory Factor Analysis (EFA) and the second (n = 3949) for the Confirmatory Factor Analysis (CFA). The EFA results in a one-factor model of the GSES scale, while the CFA suggests a two-factor solution mirroring two scales, feelings of shame and feelings of guilt. Both models have a good fit to the data, and the scale also showed high internal consistency (Cronbach’s alpha = 0.89). A nonparametric comparison of different sociodemographic groups showed a higher disposition for experiencing guilt and shame among girls, students of the ninth grade, and religious respondents. A comparison of the results to previously published results obtained from adults indicates that adolescence is a developmental period involving low differentiation between moral emotions like guilt and shame compared with adulthood. Moreover, positive association with religious attendance shows a need of addressing these issues in a pastoral care setting.

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“…The core indications for development of moral injury include self-blame, trust issues, and spiritual/existential issues (11,21,(36)(37)(38)(39). Due to the broad range of possible morally injurious events, many researchers have separated events based on individual responsibility (e.g., perpetration, failing to prevent harm) or other responsibility (e.g., witnessing disproportionate violence, betrayal by trusted others) to better understand the pathological effects of each type (28,35,(40)(41)(42).…”

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confidence: 99%

Moral Injury and PTSD: Often Co-Occurring Yet Mechanistically Different

Barnes¹,

Hurley²,

Taber³

2019

JNP

136

126

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FIGURE 1 AND COVER. Recent studies have begun to explore how the underlying neurobiology of posttraumatic stress disorder (PTSD) may be affected by the nature of the index trauma. The results of a meta-analysis that grouped task-activated (trauma reminders) functional MRI (fMRI) studies by PTSD index trauma are color-coded by trauma type (blue, sexual/physical abuse; pink, combat-related) (1). Of note, although areas of greater activation were predominately in the right hemisphere for both groups, there was little or no overlap. One study has compared resting-state regional cerebral metabolic rate between veterans with PTSD grouped by whether the index trauma was danger-and/or fear-based (i.e., life threat to self or other) or nondanger-based (i.e., witnessing violence, traumatic loss, moral injury by self or other). Regions of interest (ROIs) (yellow circles) were areas previously reported to be activated by fear stimuli (bilateral amygdalae, right rostral anterior cingulate cortex) or by traumatic script imagery (right dorsal anterior cingulate cortex, left posterior cingulate cortex, left precuneus). Danger-and/or fear-based traumas were associated with higher metabolism in the amygdala (red fill), whereas nondanger-based traumas were associated with higher metabolism in the precuneus (green fill). As noted by the authors, heightened metabolism in the precuneus for nondanger-based traumas may relate to its role in self-referential processing (2). Moral injury often co-occurs with PTSD. Moral injuries that are index traumas for PTSD are more strongly associated with emotions that developed after the event than emotions experienced during the event, suggesting that the underlying neurobiology may differ (3). An fMRI study of military veterans has explored relationships between resting-state activity (amplitude of low frequency fluctuation [ALFF]) and symptoms of PTSD (Clinician Administered PTSD Scale [CAPS]) and moral injury (Moral Injury Events Scale [MIES]) (4). CAPS score was not significantly correlated with average ALFF in any ROI. Both subscales of the MIES (transgressions, betrayals) correlated with left inferior parietal lobule ROI activity (purple circle) but in opposite directions (Cover). As discussed by the authors, these results indicate that the neural correlates of PTSD and moral injury differ at least in part (4).

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A relative weights comparison of trauma‐related shame and guilt as predictors ofDSM‐5 posttraumatic stress disorder symptom severity amongUSveterans and military members

Cited by 38 publications

References 42 publications

Religiosity and the psychological outcomes of trauma: A systematic review of quantitative studies

Religiosity and the psychological outcomes of trauma: A systematic review of quantitative studies

A Psychometric Evaluation of the Guilt and Shame Experience Scale (GSES) on a Representative Adolescent Sample: A Low Differentiation between Guilt and Shame

Moral Injury and PTSD: Often Co-Occurring Yet Mechanistically Different

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