Patterns of social-affective responses to trauma exposure and their relation to psychopathology

Abstract

Introduction: Traumatic event exposure is an important risk factor for the development and maintenance of psychopathology. Social-affective responses to trauma exposure (e.g. shame, guilt, revenge, social alienation) could moderate this relationship, but little is known about their relevance for different types of psychopathology. Moreover, the interplay of different social-affective responses in predicting psychopathology is poorly understood. Methods: In a sample of N=1321 trauma-exposed German soldiers, we examined cross-sectional associations of trauma-related social alienation, revenge, guilt and shame with both categorical (depressive disorder, alcohol use disorder, posttraumatic stress disorder) and dimensional (depression, anxiety) measures of psychopathology. Latent class analysis was conducted to identify possible patterns of trauma-related social-affective responses, and their relation to psychopathology. Results: All trauma-related social-affective responses predicted the presence of posttraumatic stress disorder, depressive disorder, alcohol use disorder and higher depressive and anxiety symptoms. Three latent classes were identified that fitted the data best, reflecting groups with (1) low, (2) moderate and (3) high risk for social-affective responses. The low-risk group demonstrated the lowest expressions on all psychopathology measures. Compared to the moderate-risk group, the high-risk group demonstrated no increased psychopathology. Conclusions: Trauma-related social alienation, shame, guilt, and revenge are characteristic of individuals with posttraumatic stress disorder, depressive disorder, alcohol use disorder, as well as with higher anxiety and depressive symptoms. There was little evidence for distinctive patterns of social-affective responses despite variation in the overall proneness to show trauma-related social-affective responses. Trauma-related social-affective responses could represent promising treatment targets which might be included in both cognitive and emotion-focused interventions.