Guilt, Shame, and Suicidal Ideation in a Military Outpatient Clinical Sample

Abstract

Guilt and shame are associated with increased severity of suicidal ideation in military mental health outpatients. Guilt has a particularly strong relationship with suicidal ideation.

Suicide risk in Iraq and Afghanistan veterans with mental health problems in VA care

“…A better understanding of barriers to engaging in care among those with suicidality is another important priority. For example, it may be that trauma-related guilt or shame associated with suicidality (e.g., Bryan et al, 2013) may be an important barrier to care. More specifically, there may be particular traumas or military experiences deemed too shameful to discuss that greatly delay or prohibit veterans from seeking treatment.…”

“…The suicide screen can be used to better understand associated risk factors in veterans who are already at high risk for suicide because of their mental health problems. OEF/OIF/OND veterans are also screened for alcohol use and traumatic brain injury, which are also known risk factors for suicide (Bryan et al, 2013;LeardMann et al, 2013).…”

The association of military and premilitary sexual trauma with risk for suicide ideation, plans, and attempts

“…Supporting this is research suggesting that male survivors of military sexual trauma are significantly less likely to seek out mental health care than female survivors (Turchik et al, 2012a). Male survivors of military sexual trauma may therefore experience a threat to their masculinity and be especially prone to shame, which has been identified as an especially strong predictor of suicide ideation and suicide attempts in military personnel (Bryan et al, 2013c). Such negative identity-based perceptions such as shame and self-hatred increase the intensity of suicide ideation and risk for future suicide attempts among military personnel and veterans (Bryan et al, 2014).…”

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.…”