PTSD Symptoms: Feelings Of Shame Worsen Psychological Wounds In Veterans

TULSA, Okla. — Post-traumatic stress disorder (PTSD) in those who are serving or have served in the military can produce a tidal wave of emotions. Now a new study reveals how certain emotions in particular can produce different psychological outcomes.

Research conducted at the University of Tulsa and analyzed by the Department of Veterans Affairs showed that both guilt and shame factor into PTSD symptoms, but feelings of shame can actually worsen a sufferer’s symptoms in comparison to a veteran’s guilt.

Stressed or frustrated man with hands on face
A recent study finds that feelings of shame can actually worsen a veteran’s symptoms of post-traumatic stress disorder (PTSD).

“The military conflicts in Iraq and Afghanistan have resulted in increased awareness of the impact of war on military service members,” says study lead Dr. Katherine C. Cunningham, in a media release. “Many returning service members and veterans have been diagnosed with PTSD, which is associated with poorer physical health, unemployment, legal problems, relationship conflict and reduced quality of life.”

Researchers conducted online psychological surveys of 61 U.S. service personnel and veterans. The data indicated PTSD symptom severity along with levels of trauma-related guilt and trauma-related shame.

Researchers found that both shame and guilt were indicators of a PTSD diagnosis. Taken together, shame and guilt accounted for a 46 percent variance in the severity of PTSD in participants. When taken separately, however, trauma-related shame had more impact on symptom severity than trauma-related guilt.

For purposes of this study, researchers say feelings of guilt were associated with having done something wrong.  As an example, participants were more likely to agree with statements such as “I didn’t keep my friend safe in combat,” or “I killed civilians during the war.”

Shame, on the other hand, was a self-directed hatred, a belief that oneself is flawed beyond repair. A person with high levels of shame would more likely agree with statements such as “I’m a failure,” or “I’m a monster.”

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Researchers say that, although we might confuse the two terms, they are quite distinct. Guilt says “I’ve done something bad.” Shame says “I am bad.” It is the difference between hating what we have done and hating ourselves.

“Guilt may result in more prosocial behavior, because the underlying attributions are tied to a specific harmful action and not to one’s identity,” explainss Cunningham. “Feeling guilty can motivate an attempt to repair and strengthen social relationships by making amends, while feeling shame can lead people to withdraw from society.”

Researchers say their study gives more evidence about how these two different emotions play out in cases of PTSD. They say that we should be concerned by both emotions, but especially when we find that service personnel exhibit signs of trauma-related shame.

“The findings of our study provide additional evidence that we should see shame and guilt as distinct emotions with unique roles in PTSD,” says Cunningham. “Given shame’s greater importance in explaining PTSD symptom severity, we should pay more attention to understanding and ameliorating it.”

The research was published Oct. 23, 2017 in the British Journal of Clinical Psychology.

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