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

Tripp, Jessica C.; McDevitt-Murphy, Meghan E.

doi:10.1111/sltb.12266

Cited by 19 publications

(9 citation statements)

References 20 publications

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“…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). …”

Section: Introductionmentioning

confidence: 99%

“…They found that guilt cognitions and distress had direct effects on PTSD and depressive symptoms, whereas global guilt did not. Tripp and McDevitt-Murphy (2016) tested the TRGI subscales as serial mediators of the relationship between PTSD and SI (refer to Figure 1A) and reported indirect effects of PTSD on SI via pathways through 1) guilt cognitions and global guilt, 2) distress and global guilt, and 3) the full model with all three subscales. These findings provided support for the existing model (i.e., Kubany & Watson, 2003) and evidence that trauma-related guilt may partially explain the relationship between PTSD symptoms and SI.…”

Section: Introductionmentioning

confidence: 99%

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

Cunningham

Farmer

LoSavio

et al. 2017

Journal of Affective Disorders

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Background Suicidal ideation (SI) is a serious issue affecting U.S. veterans, and those with posttraumatic stress disorder (PTSD) are at an especially high risk of SI. Guilt has been associated with both PTSD and SI and may therefore be an important link between these constructs. Methods The present study compared models of trauma-related guilt and used path analysis to examine the direct and indirect effects of PTSD and trauma-related guilt on SI among a sample of 988 veterans receiving outpatient PTSD treatment at a Veterans Affairs (VA) specialty clinic. Results Results showed that a model of trauma-related guilt including guilt-cognitions and global guilt (but not distress) provided the best model fit for the data. PTSD and trauma-related guilt had direct effects on SI, and PTSD exhibited indirect effects on SI via trauma-related guilt. Limitations The use of cross-sectional data limits the ability to make causal inferences. A treatment-seeking sample composed primarily of Vietnam veterans limits generalizability to other populations. Conclusions Trauma-related guilt, particularly guilt cognitions, may be an effective point of intervention to help reduce SI among veterans with PTSD. This is an important area of inquiry, and suggestions for future research are discussed.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Cunningham

Farmer

LoSavio

et al. 2017

Journal of Affective Disorders

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“…In summary, although the relationship between two or three items guilt, intrusive rumination, deliberate rumination, PTSD, and suicide risk have been examined in previous studies, the role of intrusive rumination, deliberate rumination and PTSD in the impact of guilt on suicide risk has not been explored. Previous studies investigating guilt as an important factor in suicide risk have mostly been conducted in individuals who fulfill military service or veterans (Bryan et al, 2013;Hendin & Haas, 1991;Tripp & McDevitt-Murphy, 2017). Research focusing on the effect of guilt on suicide risk in adolescent survivors of earthquakes is scarce.…”

Section: The Present Studymentioning

confidence: 99%

Longitudinal relationships between guilt and suicide risk among adolescents in a postdisaster context: Mediating roles of rumination and posttraumatic stress disorder

Wang

Yuan

et al. 2022

Suicide & Life Threat Behav

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Objective To analyze the pathways and mechanisms underlying the impact of guilt on suicide risk using a well‐controlled longitudinal study, we examined the mediating roles of intrusive rumination, deliberate rumination, and posttraumatic stress disorder (PTSD) in this association. Method Four hundred and eight adolescent survivors (Mage = 14.05 years) were assessed using self‐report questionnaires three and a half years and four and a half years after the Ya'an earthquake. The self‐report questionnaires included the Trauma Exposures Questionnaire, the Interpersonal Guilt Questionnaire, the Event‐Related Rumination Inventory, the PTSD Checklist for the DSM‐5, and the Child Behavior Problems Questionnaire. Results The results indicated that guilt had a direct and positive effect on suicide risk. Intrusive rumination and PTSD mediated the relationship between guilt and suicide risk. Guilt could increase deliberate rumination, but deliberate rumination did not significantly predict PTSD and suicide risk. Conclusion Negative postdisaster emotions, such as guilt, can enhance the combined effects of cognition and psychological disorders on suicide risk. Guilt affects suicide risk indirectly through intrusive rumination and PTSD but not through deliberate rumination.

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“…We certainly know that peri-traumatic and post-traumatic guilt cognitions can make PTSD symptoms worse (Browne et al, 2015) and that trauma-related guilt can be so distressing that it mediates the link between PTSD and suicidality (Cunningham et al, 2017;Tripp and McDevitt-Murphy, 2017). Indeed, guilt has been associated with PTSD in a range of populations (Pugh et al, 2015), including refugees (Stotz et al, 2015), veterans (Dedert et al, 2019;Henning and Frueh, 1997;Litz et al, 2009), and survivors of domestic violence (Beck et al, 2011;Street et al, 2005).…”

Section: Why Intervene To Help With Guilt?mentioning

confidence: 99%

A cognitive behavioural therapy (CBT) approach for working with strong feelings of guilt after traumatic events

Young

Chessell²,

Chisholm

et al. 2021

tCBT

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This article outlines a cognitive behavioural therapy (CBT) approach to treating feelings of guilt and aims to be a practical ‘how to’ guide for therapists. The therapeutic techniques were developed in the context of working with clients with a diagnosis of post-traumatic stress disorder (PTSD); however, the ideas can also be used when working with clients who do not meet a diagnosis of PTSD but have experienced trauma or adversity and feel guilty. The techniques in this article are therefore widely applicable: to veterans, refugees, survivors of abuse, the bereaved, and healthcare professionals affected by COVID-19, amongst others. We consider how to assess and formulate feelings of guilt and suggest multiple cognitive and imagery strategies which can be used to reduce feelings of guilt. When working with clients with a diagnosis of PTSD, it is important to establish whether the guilt was first experienced during the traumatic event (peri-traumatically) or after the traumatic event (post-traumatically). If the guilt is peri-traumatic, following cognitive work, this new information may then need to be integrated into the traumatic memory during reliving. Key learning aims (1) To understand why feelings of guilt may arise following experiences of trauma or adversity. (2) To be able to assess and formulate feelings of guilt. (3) To be able to choose an appropriate cognitive technique, based on the reason for the feeling of guilt/responsibility, and work through this with a client. (4) To be able to use imagery techniques to support cognitive interventions with feelings of guilt.

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

Cited by 19 publications

References 20 publications

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

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

Longitudinal relationships between guilt and suicide risk among adolescents in a postdisaster context: Mediating roles of rumination and posttraumatic stress disorder

A cognitive behavioural therapy (CBT) approach for working with strong feelings of guilt after traumatic events

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