Broken and guilty since it happened: A population study of trauma-related shame and guilt after violence and sexual abuse

Aakvaag, Helene Flood; Thoresen, Siri; Wentzel‐Larsen, Tore; Dyb, Grete; Røysamb, Espen; Olff, Miranda

doi:10.1016/j.jad.2016.06.004

Cited by 99 publications

(83 citation statements)

References 56 publications

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“…Depression can also manifest itself as emotional pain, for which NSSI can be an outlet. Negative statements, feelings of shame/guilt, and expression of sense of hopelessness (e.g., I hate my life, I'm of no use to anyone, I've done something awful, this is my fault, there's no hope for the future, and nothing is going to change for the better) have been observed particularly among survivors of sexual abuse (Aakvaag et al, 2016;Feiring & Taska, 2005;Gorey, Richter, & Snider, 2001). The fact that adolescents with ADHD and disruptive behavior disorder are more likely to engage in NSSI is also consistent with other past studies that suggest that adolescents who have difficulty controlling their own behavior or lack planning or insight into their actions may engage in risk-taking behaviors that put the safety of themselves and others at risk (Allely, 2014;Hinshaw et al, 2012;Meza, Owens, & Hinshaw, 2016).…”

Section: Discussionmentioning

confidence: 99%

The role of adverse childhood experiences as determinants of non-suicidal self-injury among children and adolescents referred to community and inpatient mental health settings

Baiden

Stewart

Fallon

2017

Child Abuse & Neglect

106

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The objectives of this study were to examine the prevalence of, and determine the effect of adverse childhood experiences on non-suicidal self-injury among children and adolescents referred to community and inpatient mental health settings. Data for this study were obtained from the interRAI Child and Youth Mental Health dataset. A total of 2038 children and adolescents aged 8-18 years (M = 12.49; SD = 2.88, 61.1% males) were analyzed. Binary logistic regression was fitted to identify predictors of non-suicidal self-injury as a function of adverse childhood experiences, depression, and social support while simultaneously controlling for age, gender, type of patient, legal guardianship, marital status of parents/caregivers, history of foster family placement, and mental health diagnoses. Of the 2038 children and adolescents examined, 592 (29%) of this clinical sample engaged in non-suicidal self-injury. In the multivariate logistic regression model, children and adolescents who were physically abused had 49% higher odds of engaging in non-suicidal self-injury and children and adolescents who were sexually abused had 60% higher odds of engaging in non-suicidal self-injury, when compared to their non-abused counterparts. Other predictors of non-suicidal self-injury include: older age, female gender, inpatient status, depression, attention deficit-hyperactivity disorder, disruptive behavior disorder, and mood disorders. Children and adolescents who had some form of social support had a 26% decrease in the odds of engaging in non-suicidal self-injury. Assessment procedures for indicators of mental health, particularly among children and adolescents with a history of adverse childhood experiences, should also take into account non-suicidal self-injury. In addition to bolstering social support networks, addressing depression and related emotion regulation skills in childhood may help prevent future non-suicidal self-injury behaviors.

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Section: Discussionmentioning

confidence: 99%

The role of adverse childhood experiences as determinants of non-suicidal self-injury among children and adolescents referred to community and inpatient mental health settings

Baiden

Stewart

Fallon

2017

Child Abuse & Neglect

106

View full text Add to dashboard Cite

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“…Another explanation would indicate that being emotionally wounded puts you at risk of a traumatic event. Women are often considered more sensitive to interpersonal stress, with a higher sense of guilt [22]. In this scenario, the illness is related to personality factors that augment susceptibility to trauma.…”

Section: Discussionmentioning

confidence: 99%

The epidemiology of post-traumatic stress disorder in Norway: trauma characteristics and pre-existing psychiatric disorders

Lassemo

Sandanger

Nygård

et al. 2016

Soc Psychiatry Psychiatr Epidemiol

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PurposeThe prevalence of PTSD differs by gender. Pre-existing psychiatric disorders and different traumas experienced by men and women may explain this. The aims of this study were to assess (1) incidence and prevalence of exposure to traumatic events and PTSD, (2) the effect of pre-existing psychiatric disorders prior to trauma on the risk for PTSD, and (3) the effect the characteristics of trauma have on the risk for PTSD. All stratified by gender.MethodCIDI was used to obtain diagnoses at the interview stage and retrospectively for the general population N = 1634.ResultsThe incidence for trauma was 466 and 641 per 100,000 PYs for women and men, respectively. The incidence of PTSD was 88 and 31 per 100,000 PYs. Twelve month and lifetime prevalence of PTSD was 1.7 and 4.3 %, respectively, for women, and 1.0 and 1.4 %, respectively, for men. Pre-existing psychiatric disorders were risk factors for PTSD, but only in women. Premeditated traumas were more harmful.ConclusionGender differences were observed regarding traumatic exposure and in the nature of traumas experienced and incidences of PTSD. Men experienced more traumas and less PTSD. Pre-existing psychiatric disorders were found to be risk factors for subsequent PTSD in women. However, while trauma happens to most, it only rarely leads to PTSD, and the most harmful traumas were premeditated ones. Primary prevention of PTSD is thus feasible, although secondary preventive efforts should be gender-specific.

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“…We excluded items reflecting behavioural guilt (e.g., ‘I did something I should not have done’), cognitive self‐blame (e.g., ‘I am responsible for what happened’ or ‘I blame myself for what happened’), and ambiguous content (e.g., ‘What happened causes me a lot of emotional distress’). The final trauma‐related shame variable was composed of a total of 30 items extracted from the Trauma‐Related Shame Inventory (TRSI, 19 items; Øktedalen et al ., ), Trauma Appraisal Questionnaire (TAQ, eight items; DePrince, Zurbriggen, Chu, & Smart, ), and Shame and Guilt After Trauma Scale (SGATS, three items; Aakvaag et al ., ). Internal consistency among selected shame items in the current sample was excellent (α = .96).…”

Section: Methodsmentioning

confidence: 97%

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

Cunningham

Davis

Wilson

et al. 2017

British J Clinic Psychol

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Trauma-related shame and guilt explained almost half of the observed variance in PTSD symptom severity among this sample of US military veterans and service members. Trauma-related shame and guilt each made a unique contribution to PTSD severity after accounting for the similarity between these two emotions; however, shame was particularly associated with increased PTSD severity. These results highlight the importance of assessing and addressing trauma-related shame and guilt in PTSD treatment among military populations. We suggest that emotion- and compassion-focused techniques may be particularly relevant for addressing trauma-related shame and guilt. Limitations of the study Cross-sectional data does not allow for determination of causal relationships. Although sufficiently powered, the sample size is small. The present sample self-selected to participate in a study about stress and emotions.

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Broken and guilty since it happened: A population study of trauma-related shame and guilt after violence and sexual abuse

Cited by 99 publications

References 56 publications

The role of adverse childhood experiences as determinants of non-suicidal self-injury among children and adolescents referred to community and inpatient mental health settings

The role of adverse childhood experiences as determinants of non-suicidal self-injury among children and adolescents referred to community and inpatient mental health settings

The epidemiology of post-traumatic stress disorder in Norway: trauma characteristics and pre-existing psychiatric disorders

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

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