Guilt as a Mediator of the Relationship Between Depression and Posttraumatic Stress With Suicide Ideation in Two Samples of Military Personnel and Veterans

Abstract

Depression, posttraumatic stress (PTS), and guilt have been implicated as risk factors for suicide ideation (SI) among military personnel and veterans. Conceptual and empirical work suggests that guilt may mediate the relationship of depression and PTS with SI. The current study explored this hypothesis in two cross-sectional samples of military personnel and veterans (n = 464 and n = 158). Path analyses showed good fit for both samples [Sample 1: χ 2 (1) = 2.18, p = .140; CFI = 1.00; RMSEA = .05; WRMR = .23; Sample 2: χ 2 (2) = 1.39, p = .499; CFI = 1.00; RMSEA = .00; SRMR = .02] and indicated that depression was indirectly related to SI through guilt for both samples (ps < .038). Furthermore, guilt partially mediated the relationship of PTS with SI (p = .033) in Sample 1 and fully mediated the relationship (p = .016) in Sample 2. The present findings suggest that guilt may be a mechanism for increased risk among suicidal military personnel and veterans with depression and PTS.

Trauma‐Related Guilt Mediates the Relationship between Posttraumatic Stress Disorder and Suicidal Ideation in OEF/OIF/OND Veterans

“…These findings are similar to Bryan et al. 's () study, which found that overall guilt mediated the relationship between symptoms of PTSD and depression and SI.…”

Treating PTSD Within the Context of Heightened Suicide Risk

“…Negative self-concept, in particular, appears to be especially key to understanding the emergence of suicidal thoughts and behaviors within the context of PTSD. Guilt, remorse, self-blame, and self-criticism not only increase risk of suicidal thoughts and behaviors [20][21][22][23][24]; accumulating evidence suggests they explain the relationship of PTSD with suicide-related outcomes [22,25,26]. Guilt has also been found to be a risk factor for the later development of other trauma-related sequelae such as depression and substance use disorders [27][28][29][30][31], each of which serves as a suicide risk factor in its own right.…”

A model comparison approach to trauma-related guilt as a mediator of the relationship between PTSD symptoms and suicidal ideation among veterans

“…Initial evidence supports this hypothesis. Results from Bryan et al (2013) suggested that guilt and shame together mediated the relationship between PTSD and SI, and further research showed that guilt partially mediated the relationship between PTSD and SI (Bryan et al, 2015). A recent study of Iraq and Afghanistan veterans also showed that trauma-related guilt mediated the relationship between PTSD symptoms and SI (Tripp & McDevitt-Murphy, 2016).…”