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PubMed2004

Trauma, change in strength of religious faith, and mental health service use among veterans treated for PTSD.

One of the most pervasive effects of traumatic exposure is the challenge that people experience to their existential beliefs concerning the meaning and purpose of life. Particularly at risk is the strength of their religious faith and the comfort that they derive from it. The purpose of this study is to examine a model of the interrelationships among veterans' traumatic exposure, posttraumatic stress disorder (PTSD), guilt, social functioning, change in religious faith, and continued use of mental health services. Data are drawn from studies of outpatient (N = 554) and inpatient (N = 831) specialized treatment of PTSD in Department of Veterans Affairs programs. Structural equation modeling is used to estimate the parameters of the model and evaluate its goodness of fit to the data. The model achieved acceptable goodness of fit and suggested that veterans' experiences of killing others and failing to prevent death weakened their religious faith, both directly and as mediated by feelings of guilt. Weakened religious faith and guilt each contributed independently to more extensive use of VA mental health services. Severity of PTSD symptoms and social functioning played no significant role in the continued use of mental health services. We conclude that veterans' pursuit of mental health services appears to be driven more by their guilt and the weakening of their religious faith than by the severity of their PTSD symptoms or their deficits in social functioning. The specificity of these effects on service use suggests that a primary motivation of veterans' continuing pursuit of treatment may be their search for a meaning and purpose to their traumatic experiences. This possibility raises the broader issue of whether spirituality should be more central to the treatment of PTSD, either in the form of a greater role for pastoral counseling or of a wider inclusion of spiritual issues in traditional psychotherapy for PTSD.

Ambulatory Care↗

PubMed2007

Moral emotions and moral behavior.

Moral emotions represent a key element of our human moral apparatus, influencing the link between moral standards and moral behavior. This chapter reviews current theory and research on moral emotions. We first focus on a triad of negatively valenced "self-conscious" emotions-shame, guilt, and embarrassment. As in previous decades, much research remains focused on shame and guilt. We review current thinking on the distinction between shame and guilt, and the relative advantages and disadvantages of these two moral emotions. Several new areas of research are highlighted: research on the domain-specific phenomenon of body shame, styles of coping with shame, psychobiological aspects of shame, the link between childhood abuse and later proneness to shame, and the phenomena of vicarious or "collective" experiences of shame and guilt. In recent years, the concept of moral emotions has been expanded to include several positive emotions-elevation, gratitude, and the sometimes morally relevant experience of pride. Finally, we discuss briefly a morally relevant emotional process-other-oriented empathy.

Adult↗

PubMed1979

Japanese psychoanalysis and the Ajase complex (Kosawa).

In 1932, Kosawa visited Freud at 19 Berggasse, and submitted to him a paper entitled: 'Two kinds of guilt feelings, the Ajase complex. In his paper, Kosawa expounded his theory of the Ajase complex, rooted in Buddhist thought. He discussed the psychological peculiarity of the Japanese as evidenced by the acceptance of oral dependency toward the mother, the repression of the resentment at the mother and 'guilt feeling over being forgiven' and a need to make restitution for harboring this evil intent. This type of guilt feeling is quite different from the guilt feeling as a fear of punishment which Freud embodied in his theory of the Oedipus complex.

Buddhism↗

PubMed2001

A psychoanalytic view of Biblical myth.

The author looks at some ways in which certain biblical myths tell a story, a story about loss--loss of freedom, of the homeland, of God's favour, ultimately loss of the good object--and about guilt for these losses. He describes in the post-exilic myth of the Old Testament and the Jesus myth of the New Testament a pattern in which, he argues, there is a 'retreat' from the depressive anxieties that seem to be troubling the group, with loss and guilt becoming mediated through a rigidified defensive organisation that holds out the promise that it will make this loss and guilt easier to bear. Guilt, worthlessness, badness and fallibility are split off and projected into a near foreign group blamed for loss, while within the group's own boundary there is an identification with righteousness and power. The author describes the post-exilic myth and the Jesus myth as what he terms 'hardened myths' that embody a belief in an idealized privileged identity in which exclusive group possession of the good object is asserted. The analysis of such hardened myths reveals a shared belief in the efficacy of group idealization. The author links the formation of these hardened myths with what we know about how individuals manage actual loss, and argues that (for the group as for the individual) the myths express collusion with the moral authority of an idealized and very punitive superego. The paper ends with a very brief suggestion that, analogously, hardened myths may be relevant in other cultural and social millieux, especially, perhaps, the troubled relations of some psychoanalytic groups to one another.

Anxiety↗

PubMed2006

Image and trauma.

In 1980, when the diagnosis of Posttraumatic Stress Disorder (PTSD) was introduced into the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-III), survivor guilt--a symptom long associated with trauma of the Holocaust and other extreme experiences--was included in the list of symptom criteria. But in the revised edition of the manual of 1987 (DSM-IIIR), survivor guilt was demoted to the status of merely an "associated feature" of the condition. Now that survivor guilt has disappeared from the official lexicon of trauma, shame has come to take its place as the emotion that most defines the traumatic state. This paper examines the rationale for the shift from survivor guilt to shame in the context of the American Psychiatric Association's revisions. It argues that the shift can be understood as yet another manifestation of the oscillation between mimetic and antimimetic theories of trauma that, I have argued in my book Trauma: A Genealogy (2000), has structured the understanding of trauma from the start.

History, 20th Century↗

PubMed2004

How jurors use and misuse character evidence.

The Federal Rules of Evidence allow defendants to offer testimony about their good character, but that testimony can be impeached with cross-examination or a rebuttal witness. It is assumed that jurors use the defense's character evidence (CE) to form guilt and conviction judgments but use impeachment evidence only to assess the character witness's credibility. Two experiments tested these assumptions by presenting mock jurors with various forms of CE and impeachment. Participants made trait ratings for the character witness and defendant and guilt and conviction judgments. Positive CE did not affect guilt or conviction judgments, but cross-examination caused a backlash in which judgments were harsher than when no CE was given. Using path analysis, the authors tested a model of the process by which CE and impeachment affect defendant and witness impressions and guilt and conviction judgments. Implications for juror decision making are discussed.

Character↗

PubMed2006

Foundations for self-awareness: An exploration through autism.

Developmental psychopathology holds promise for elucidating the structure of self-awareness. Here we studied social emotions in matched groups of children and adolescents with and without autism. Our aims were to determine whether there are potentially dissociable aspects of self-awareness, and to reconsider how the qualities of young children's engagement with other persons influences the development of their sense of self. Parent interviews yielded evidence that children with autism are limited in social-relational and emotional domains of self-awareness; for example, few were reported to show guilt, embarrassment, or shame. Yet according to parent report, most were affected by the moods of others, showed some degree of pity and concern, and manifested jealousy. When presented with videotaped scenes, participants with autism were similar to those without autism in identifying pride, guilt, and shame, and they were able to describe their own experiences of pride and, more rarely, guilt. In situations designed to elicit emotions, participants with autism were rated as showing pride, but they manifested lesser degrees and atypical qualities of guilt and coyness. Relatively few showed personal forms of self-consciousness when asked to pose for a photograph. We argue that in order for children to achieve depth in self-awareness, and to relate to themselves as occupying a distinctive stance within a framework of mutual self-other relatedness, they need to identify with the attitudes of other people. We interpret the present studies in terms of dissociations among three forms of social emotion: "person-centered" qualities of relational self-awareness that require identification and are specifically limited among children with autism, more diffuse modes of relational self-consciousness, and a third group of social emotions, epitomized by jealousy, situated in a separate developmental line. We propose a rebalancing of emotion theory that gives greater prominence to children's developing forms of interpersonal and intra-psychic relatedness.

Affect↗

PubMed2003

Reassessing the dimensionality of the moral emotions.

The dimensionality of the moral emotions was tested to examine whether theoretical distinctions between specific emotions were empirically supported. A total of 720 drink-driving offenders indicated the degree to which they experienced feelings associated with the moral emotions, in an interview conducted after attending court or a restorative justice conference. Expected distinctions between shame and guilt were not found. Instead the principal components analysis identified three factors: shame-guilt, embarrassment-exposure, and unresolved shame. The results also show that shame-guilt was related to higher feelings of empathy and lower feelings of anger/hostility. It is concluded that differences between shame and guilt may be overstated. Furthermore, it is suggested that the relationship between situational experiences of shame and the disposition to feel it may be more complicated than initially thought.

Adult↗

PubMed1986

A psychoanalytic approach to ethics.

The paper addresses some of the problems of the relationship between ethics and psychology. Philosophical assumptions which are considered are shown to bear directly on the source of the conviction that one ought to behave in some particular way. The choice of an "empirical" ethic, i.e., an epistomology which rests on psychology, is perceived to be a confusing pseudo-scientific error, which has developed in response to increasing guilt. Guilt is seen to play a central role in the evolution of the superego and the self, considered from both an ontological and and phylogenetic basis. These problems, first presented in Civilization and Its Discontents (Freud, 1930), are considered from the standpoint of what is known about normal superego development, the influence of social and historical forces on such development, and pathological superego development. The Kantian assumption of a transcendent moral authority is shown to be related to the earliest symbiotic unity of mother and child, in the context of the first internalized constraints on the aggressive and libidinal drives. The burden of such constraints is seen to be guilt, increasingly less tolerable through the interaction of social, historical, and psychological influences. The response to this guilt is a major influence in the denial of a transcendent moral authority, and the shift toward fewer constraints on the drives. The more obvious social and political consequences are considered.

Aggression↗

PubMed1999

[Delirium and hallucinations in depression: cultural aspects].

Study of depression in North-Africa and Sub-Saharan Africa has shown that, since the seventies, the clinical expression of depression is markedly different from that of depression in the West. Several authors have noted the rareness of guilt themes and the frequency of persecution themes and somatic complaints in depressed Africans, even those living in the West. More recent studies have shown an evolution in depressive symptoms in North-Africa with an increase in guilt and a decrease in persecution and somatic complaints. This shift in symptoms brings the expression of depression closer to that observed in the West. Our study addresses delusional depression: in 73 cases of delusional depression, delusions of guilt were present in 31% of cases, persecution in 48% and hallucinations in 31.5%. A comparison of the sub-groups consulting in 1991 and a second sub-group consulting in 1998 shows a marked increase in guilt (23.5 versus 39%).

Adult↗

PubMed2001

Personality features and characteristics of violent events committed by juvenile offenders.

The present study investigated the relationship between characteristics of a violent event, as self-reported by 82 incarcerated juvenile offenders, and personality features measured by the Millon Adolescent Clinical Inventory (MACI). The study predicted that specific personality features that have previously been associated with psychopathy would be associated with the instrumentality, emotional reactivity, and empathy or guilt reported for the incident. Results confirmed that a self-reported pattern of elevated instrumental motivation and reduced empathy or guilt was associated with higher scores on the MACI Forceful, Unruly, Substance Abuse Proneness, Impulsive Propensity, and Family Discord Scales, as well as a recently developed Psychopathy Content Scale. Self-reported elevated instrumental motivation and reduced empathy or guilt was also associated with lower scores on the Submissive, Conforming, Anxious Feelings, and Sexual Discomfort Scales. There were no significant relationships observed between emotional reactivity and personality scales.

Adolescent↗

PubMed2004

Psychologic distress after disclosure of genetic test results regarding hereditary nonpolyposis colorectal carcinoma.

BACKGROUND: To the authors' knowledge, there have been few studies of the psychologic distress after disclosure of genetic test results for hereditary nonpolyposis colorectal carcinoma (HNPCC). The objectives of this study were to identify the prevalence rates and predictors of psychologic distress and to evaluate the feelings of guilt after disclosure of the test results in Japanese probands and unaffected relatives. METHODS: Probands and unaffected relatives were interviewed immediately after the first genetic counseling session for HNPCC and again 1 month after disclosure of the genetic test results. The prevalence of major and minor depression, acute stress disorder (ASD), posttraumatic stress disorder (PTSD), and posttraumatic stress symptoms (PTSS) were assessed using the Structured Clinical Interview based on the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition revised (DSM-III-R) or the DSM-IV; feelings of guilt were investigated using a numeric scale and a semistructured interview. RESULTS: Among 47 participants who completed the baseline interview, 42 participants (89%) completed the 1-month follow-up interview. Although none of the participants met the criteria for major depression, ASD, or PTSD at the follow-up interview, 3 of 42 participants (7%) met the criteria for minor depression and 2 participants (5%) had PTSS. The only predictor of psychologic distress found was the presence of a history of major or minor depression (odds ratio, 19.41; 95% confidence interval, 1.42-264.95; P < 0.05). Five of 42 participants (12%) had feelings of guilt. CONCLUSIONS: Disclosure of genetic test results for HNPCC may not cause significant psychologic distress in Japanese probands or relatives. However, healthcare providers should not neglect to assess these individuals for psychologic responses, such as minor depression and PTSS.

Adult↗

PubMed2006

An update on the definition of "excessive exercise" in eating disorders research.

OBJECTIVE: The current study informed the definition of "excessive exercise" by examining relations between exercise behavior, eating-disordered behavior, and quality of life (QOL) in a community sample of women. METHOD: Self-report measures of frequency of exercise, obligatory exercise and motivation for exercise, and of eating disorder psychopathology and QOL, were completed by 3,472 women aged 18-42 years who engaged in regular exercise. RESULTS: The extent to which exercise is intended to influence weight or shape and the degree to which guilt is experienced when exercise is postponed were the exercise variables most strongly associated with elevated levels of eating disorder psychopathology and reduced QOL. Subgroups of participants who reported exercising solely for weight and shape reasons (n = 322 [9.3%]), intense guilt after postponement of exercise (n = 136 [3.9%]), or both (n = 116 [3.3%]), had markedly elevated levels of eating disorder psychopathology. There was no association between excessive exercise and reduced QOL after the effects of eating disorder psychopathology were statistically controlled. CONCLUSION: The findings suggest that exercise is excessive when its postponement is accompanied by intense guilt or when it is undertaken solely to influence weight or shape. Operational definitions of excessive exercise might usefully include reference to these terms. The findings may also be of benefit in informing the content of prevention programs, which address dysfunctional exercise behavior. Excessive exercise is unlikely to be associated with impairment in psychosocial functioning in the absence of eating disorder psychopathology. It may, however, be a useful indicator of such psychopathology.

Activities of Daily Living↗

PubMed1987

The relationship between affective and cognitive components of homophobic reaction.

The affective component of homophobia was explored by a factor-analytic study and related to the cognitive component. Eighty-one undergraduate students read an anecdote with either homosexual or heterosexual content. Subjects' affects were measured with an adjective checklist, and subjects' cognitions were measured as to their attitudes toward homosexuality with the Attitudes Toward Homosexuality Scale (ATHS). Results suggest two affective homophobia factors: homophobic anger and homophobic guilt. Homophobic anger correlates strongly with the cognitive component (ATHS), r = -0.73, whereas homophobic guilt does not correlate with the cognitive component (ATHS), r = 0.02. Homophobic guilt seems unrelated to homophobic attitude. Adjective checklists appear useful for measuring affective components of homophobia.

Adult↗

PubMed1979

Ego development and sex attitudes in heterosexual and homosexual men and women.

A comparison was made of heterosexual and homosexual men and women utilizing Loevinger's concept of ego development and focusing on the relationships among ego levels and attitudes toward homosexuality and on personal sex guilt and other sociosexual variables. Previous comparative studies were critically analyzed with respect to the adequacy of definition and description of sampling procedures, and the appropriateness of research question. A pilot study reported here concerns the development of a measure of "attitudes toward homosexuality." The major study utilized 200 subjects who completed an anonymous and lengthy questionnaire. This sample was relatively young, well-educated, white, and Protestant. Self-ratings on the two Kinsey-type scales clearly differentiated the self-identified primarily heterosexual and homosexual groups. In this study there were no significant differences in ego levels between the heterosexual and the homosexual groups, suggesting that ego development and sexual orientation development are independent phenomena. Among both homosexual and heterosexual subjects there were low but significant correlations between higher levels of ego development and more positive attitudes toward homosexuality. More negative attitudes toward homosexuality were correlated with higher levels of personal sex guilt for heterosexual and homosexual men and for heterosexual women. Our measure of sex guilt proved to be related to ego level only for heterosexual males, although the measure of this construct requires additional research and refinement. Other correlates of these variables are also reported.

Adaptation, Psychological↗

PubMed2006

Everyday mood and emotions after eating a chocolate bar or an apple.

Emotional changes after eating chocolate were examined in everyday life. Thirty-seven healthy, normal-weight women ate a chocolate bar, an apple or nothing and rated their subjective state 5, 30, 60 and 90min after eating. Both chocolate and the apple reduced hunger, elevated mood and increased activation, but the effects of the chocolate were stronger. Eating chocolate was also followed by joy and, in some women, by guilt. Guilt responders experienced less intense positive emotions. Whereas positive emotional responses appear to be due to sensory pleasure and it's anticipation and may also be related to reduced hunger, guilt responses are probably induced by negative food-related cognitions.

Adult↗

PubMed2006

What does it mean to be angry at yourself? Categories, appraisals, and the problem of language.

According to appraisal theorists, anger involves a negative event, usually blocking a goal, caused by another person. Critics argue that other-agency is unnecessary, since people can be angry at themselves, and thus that appraisal theory is wrong about anger. In two studies, we compared anger, self-anger, shame, and guilt, and found that self-anger shared some appraisals, action tendencies, and associated emotions with anger, others with shame and guilt. Self-anger was not simply anger with a different agency appraisal. Anger, shame, and guilt almost always involved other people, but almost half of the occurrences of self-anger were solitary. We discuss the incompatibility of appraisal theories with any strict categorical view of emotions, and the inadequacy of emotion words to capture emotional experience.

Adult↗

PubMed2005

The potential impact of genetic counseling for mental illness.

Mental disorders are relatively highly heritable, yet complex with important interactions between genetic risk and environmental factors in determining illness expression. Due to the high prevalence of these complex disorders, steady increase in knowledge about genetic contributions, and increasing public awareness, this area may come to represent a significant proportion of all genetic counseling. The potential impact of genetic counseling in mental illness is broad. As well as the conventional expectations, genetic counseling may have the positive outcomes of reducing the guilt, shame, and stigma associated with mental illness, even within families. However, like many interventions in medicine, genetic counseling for mental disorders could potentially have unintended consequences resulting in increased stigma, guilt, and shame. The potential impacts of genetic education and providing recurrence risks on stigma are reviewed, as well as the role of education about the environment as a way of modifying family members' guilt. The review allows a preliminary formulation of a series of suggestions for genetic counseling in mental illness.

Attitude to Health↗