Role of morality in the experience of guilt and shame within the armed forces

Nazarov, Anthony; Jetly, Rakesh; McNeely, Heather E.; Kiang, Michael; Lanius, Ruth A.; McKinnon, Margaret C.

doi:10.1111/acps.12406

Cited by 89 publications

(77 citation statements)

References 105 publications

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“…Recent theories postulate that these experiences of shame and guilt may play a central role in PTSD symptomology (Herman, 2011; Leskela, Dieperink, & Thuras, 2002; Matos & Pinto-Gouveia, 2010). For example, guilt and shame symptoms are frequently associated with perceived perpetration of and exposure to moral transgressions in military members with PTSD, potentially mediating the relation between trauma exposure and symptom severity in PTSD and major depressive disorder (MDD) (see Nazarov, Jetly, et al 2015, for review). Symptoms of shame and guilt also arise frequently in individuals who have been victimized (e.g., through physical and sexual assault, transportation accidents, and developmental trauma; Budden, 2009; Herman, 1992).…”

Section: Discussionmentioning

confidence: 99%

Moral reasoning in women with posttraumatic stress disorder related to childhood abuse

Nazarov

Walaszczyk

Frewen

et al. 2016

European Journal of Psychotraumatology

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BackgroundPreliminary evidence suggests that relative to healthy controls, patients with posttraumatic stress disorder (PTSD) show deficits on several inter-related social cognitive tasks, including theory of mind, and emotion comprehension. Systematic investigations examining other aspects of social cognition, including moral reasoning, have not been conducted in PTSD stemming from childhood trauma.ObjectiveTo conduct a comprehensive assessment of moral reasoning performance in individuals with PTSD stemming from childhood abuse.MethodMoral reasoning performance was assessed in 28 women with PTSD related to prolonged childhood trauma and 19 matched healthy controls. Performance was assessed using 12 modified moral dilemmas and was queried in three domains: utilitarian/deontological sacrificial dilemmas (personal and impersonal), social order vs. compassion, and altruism vs. self-interest. Participants were asked whether a proposed action was morally acceptable or unacceptable and whether or not they would perform this action under the circumstances described.ResultsWomen with PTSD were less likely to carry out utilitarian actions in personal, sacrificial moral dilemmas, a choice driven primarily by consequential intrapersonal disapproval. Increased concern regarding intrapersonal disapproval was related to higher symptoms of guilt in the PTSD group. Patients with PTSD demonstrated less altruistic moral reasoning, primarily associated with decreased empathic role-taking for beneficiaries.ConclusionsWomen with PTSD due to childhood trauma show alterations in moral reasoning marked by decreased utilitarian judgment and decreased altruism. Childhood trauma may continue to impact moral choices made into adulthood.Highlights of the articleMoral judgment processing was found to be altered in women with PTSD related to chronic childhood trauma.In comparison to healthy women, women with PTSD were less likely to approve utilitarian actions when required to assume their agency in dilemmas involving the infliction of direct physical harm.Decreased likelihood of utilitarian action approval by the PTSD sample was driven by significantly enhanced endorsement of guilt and shame as consequences of such actions.Endorsement of guilt and shame in moral dilemmas was related to increased severity of current clinical symptoms of guilt.

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Section: Discussionmentioning

confidence: 99%

Moral reasoning in women with posttraumatic stress disorder related to childhood abuse

Nazarov

Walaszczyk

Frewen

et al. 2016

European Journal of Psychotraumatology

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“…131,139,142 These findings are of particular importance given recent models emphasizing the importance of shame and guilt-based cognitions in the development and maintenance of PTSD. 41,153 Finally, improvements in facets of mindfulness, namely nonreactivity and acting with awareness, have been associated with reduction in hyperarousal symptoms, suggesting that a greater ability to remain in the present moment and be nonreactive to environmental stimuli is a mechanism of change for this symptom cluster.…”

Section: Mindfulness-based Approaches In the Treatment Of Ptsdmentioning

confidence: 99%

Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence

Boyd

Lanius

McKinnon

2018

jpn

278

177

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“…Frequently, guilt and shame are the central trauma-related emotions reported by soldiers following combat missions. In their study, Nazarov et al [31] noted a connection between moral traumas, deployment-related psychological disorders and symptoms of guilt and shame with soldiers. Similarly, the findings reported by Hellenthal et al [32] underscored a direct link between posttraumatic symptoms and “moral injury” experienced by German soldiers deployed in Afghanistan.…”

Section: Discussionmentioning

confidence: 99%

Guilt, Shame and Compassionate Imagery in War: Traumatized German Soldiers with PTSD, a Pilot Study

Alliger-Horn

Zimmermann

Schmucker³

2016

JCM

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Background: The consideration of specific trauma-associated emotions poses a challenge for the differential treatment planning in trauma therapy. Soldiers experiencing deployment-related posttraumatic stress disorder often struggle with emotions of guilt and shame as a central component of their PTSD. Objective: The purpose of this study was to examine the extent to which soldiers’ PTSD symptoms and their trauma-related guilt and shame may be affected as a function of their ability to develop compassionate imagery between their CURRENT SELF (today) and their TRAUMATIZED SELF (back then). Method: The sample comprised 24 male German soldiers diagnosed with PTSD who were examined on the Posttraumatic Diagnostic Scale (PDS) and two additional measures: the Emotional Distress Inventory (EIBE) and the Quality of Interaction between the CURRENT SELF and the TRAUMATIZED SELF (QUI-HD: Qualität der Interaktion zwischen HEUTIGEN ICH und DAMALIGEN ICH) at pre- and post-treatment and again at follow-up. The treatment used was imagery rescripting and reprocessing therapy (IRRT). Results: Eighteen of the 24 soldiers showed significant improvement in their PTSD symptoms at post-treatment and at follow-up (on their reliable change index). A significant change in trauma-associated guilt and shame emerged when compassionate imagery was developed towards one’s TRAUMATIZED SELF. The degree and intensity of the guilt and shame felt at the beginning of treatment and the degree of compassionate imagery developed toward the TRAUMATIZED SELF were predictors for change on the PDS scores. Conclusions: For soldiers suffering from specific war-related trauma involving PTSD, the use of self-nurturing, compassionate imagery that fosters reconciling with the traumatized part of the self can effectively diminish trauma-related symptoms, especially when guilt and shame are central emotions.

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Role of morality in the experience of guilt and shame within the armed forces

Cited by 89 publications

References 105 publications

Moral reasoning in women with posttraumatic stress disorder related to childhood abuse

Moral reasoning in women with posttraumatic stress disorder related to childhood abuse

Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence

Guilt, Shame and Compassionate Imagery in War: Traumatized German Soldiers with PTSD, a Pilot Study

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