Shame and posttraumatic stress disorder

Abstract

Guilt about surviving a traumatic event is thought to be an associated feature of posttraumatic stress disorder (PTSD). Shame is an emotion closely related to guilt but is a distinct affective state. Little is known regarding the role of shame in PTSD and there are no studies of PTSD where shame and guilt are examined simultaneously. We used a measure of shame- and guilt-proneness in 107 community residing former prisoner of war veterans all of whom had been exposed to trauma. The measure of shame-proneness was positively correlated with PTSD symptom severity whereas guilt-proneness was not. This study provides the first empirical data regarding a possible role for shame in PTSD and may have important therapeutic and theoretical implications.

Remorse, psychopathology, and psychopathy among adolescent offenders.

“…These included depression, anxiety, suicide ideation, and somatic complaints. These results are consistent with prior research indicating similar relationships among noncriminal, community adults (e.g., Andrews et al, 2000, Ashby et al, 2006, Ghatavi et al 2002, Harper & Arias, 2004, Leskela et al, 2002, Sanftner et al, 1995. Accordingly, our findings further underscore the harmful nature of shame (e.g., Tangney & Dearing, 2002), and suggest that its relationship with psychopathology generalizes to an adolescent offender population.…”

“…Guilt, in contrast, is not associated with problems such as depression, anxiety, and low self-esteem (Leskela et al, 2002;Quiles & Bybee, 1997;Schaefer, 2000;Stuewig & McCloskey, 2005;Tangney & Dearing, 2002). Guilt may even serve as a protective factor against psychopathology in some cases, as it is associated with better anger management (Tangney et al, 1992), later onset of alcohol use (Tangney & Dearing, 2002), and reduced likelihood of drug and alcohol problems (Dearing et al, 2005).…”

Victims of rape show increased cortisol responses to trauma reminders: A study in individuals with war- and torture-related PTSD

“…However, in our sample potentially shameful experiences were not only reported by rape victims but also from PTSD patients from the non-raped group (e.g., unwanted touching, twisting or squeezing of genitals during torture, witnessing family members being sexually assaulted), who did not show salivary cortisol reactions during the report of these events. Moreover, in PTSD patients, shame seems to be positively correlated with PTSD symptom severity (Leskela et al, 2002), and our two trauma groups did not differ with respect to the severity of their symptoms. In contrast to the pronounced effect of trauma type on salivary cortisol levels which primarily reflects the unbound, active hormone portion, we did not find an effect for trauma type on total plasma cortisol composed of active and bound hormone fractions.…”

Moral Emotions and Moral Behavior

“…Research over the past two decades consistently indicates that proneness to shame is related to a wide variety of psychological symptoms. These run the gamut from low self-esteem, depression, and anxiety to eating disorder symptoms, posttraumatic stress disorder (PTSD), and suicidal ideation , Ashby et al 2006, Crossley & Rockett 2005, Feiring & Taska 2005, Feiring et al 2002, Ferguson et al 2000, Ghatavi et al 2002, Harper & Arias 2004, Henderson & Zimbardo 2001, Leskela et al 2002, Mills 2003, Murray et al 2000, Orsillo et al 1996, Sanftner et al 1995, Stuewig & McCloskey 2005; see also review in Tangney & Dearing 2002). The negative psychological implications of shame are evident across measurement methods, diverse age groups, and populations.…”

“…Numerous independent studies converge: guilt-prone children, adolescents, and adults are not at increased risk for depression, anxiety, low self-esteem, etc. Leskela et al 2002;McLaughlin 2002;Quiles & Bybee 1997;Schaefer 2000;Stuewig & McCloskey 2005;Tangney 1994;Tangney & Dearing 2002;Tangney et al 1991Tangney et al , 1992.…”