PubMed · 13528221
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C H NODET. [Psychoanalysis & guilt feeling].. https://pubmed.ncbi.nlm.nih.gov/13528221/
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Post-traumatic stress disorder is currently classified as an anxiety disorder with fear as the predominant emotion. This has led to the development of treatment techniques such as exposure aimed at alleviating fear. This article highlights the need to address other emotional responses, in particular shame and guilt, when assessing and treating PTSD. Hence, it presents two clinical models of shame-based PTSD and guilt-based PTSD. These models are offered as aids to clinicians in assessing and formulating cases of PTSD where shame and guilt are salient issues. The models highlight the importance of assessing meaning in the context of pre-existing schemas and address two pathways to the development of shame and/or guilt: schema congruence and schema incongruence. Several treatment implications are drawn from the models.
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Vietnam combat veterans (N = 151) with chronic posttraumatic stress disorder (PTSD) completed measures of atrocities exposure, combat exposure, PTSD symptom severity, guilt and interpersonal violence. PTSD symptom severity, guilt and interpersonal violence rates were similar to previously reported studies that examined treatment seeking combat veterans with PTSD. Controlling for combat exposure, endorsement of atrocities exposure was related to PTSD symptom severity, PTSD B (reexperiencing) symptoms, Global Guilt, Guilt Cognitions, and cognitive subscales of Hindsight-Bias/Responsibility and Wrongdoing. These results are discussed in the context of previous research conducted regarding atrocities exposure and PTSD.