A review of PTSD and shame in military veterans

Journal of Human Behavior in the Social Environment

Volumn 26, Issue 1, 2016, Pages 56-68

  Gaudet, Camille M ^a   Sowers, Karen M ^a   Nugent, William R ^a   Boriskin, Jerry A ^b  

^a UNIVERSITY OF TENNESSEE   (United States)

^b VA NORTHERN CALIFORNIA HEALTH CARE SYSTEM   (United States)

Author keywords

Military; moral injury; PTSD; shame; trauma; veterans

Indexed keywords

EID: 84947490921     PISSN: 10911359     EISSN: 15403556     Source Type: Journal    
DOI: 10.1080/10911359.2015.1059168     Document Type: Article

References (60)

1. A.B.Adler,, K.M.Wright,, P.D.Bliese,, R.Eckford,, & C.W.Hoge, (2008). A2 diagnostic criterion for combat‐related posttraumatic stress disorder. Journal of Traumatic Stress, 21(3), 301–308. doi:10.1002/(ISSN)1573-6598
2. American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
3. American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
4. B.Andrews,, C.R.Brewin,, L.Stewart,, R.Philpott,, & J.Hejdenberg, (2009). Comparison of immediate-onset and delayed-onset posttraumatic stress disorder in military veterans. Journal of Abnormal Psychology, 118(4), 767–777. doi:10.1037/a0017203
5. B.Andrews,, M.Qian,, & J.D.Valentine, (2002). Predicting depressive symptoms with a new measure of shame: The experience of shame scale. British Journal of Clinical Psychology, 41(1), 29–42. doi:10.1348/014466502163778
6. T.W.Baskin,, & R.D.Enright, (2004). Intervention studies on forgiveness: A meta analysis. Journal of Counseling & Development, 82(1), 79–90. doi:10.1002/j.1556-6678.2004.tb00288.x
7. J.Bisson,, & M.Andrew, (2007). Psychological treatment of post-traumatic stress disorder (PTSD) (Review). Cochrane Database of Systematic Reviews, 18(3), 1–117, Art. No.: CD003388, Wiley. doi:10.1002/14651858.CD003388.pub3
8. S.J.Blatt, (1995). The destructiveness of perfectionism: Implications for the treatment of depression. American Psychologist, 50(12), 1003–1020. doi:10.1037/0003-066X.50.12.1003
9. A.Blum, (2008). Shame and guilt, misconceptions and controversies: A critical review of the literature. Traumatology, 14(3), 91–102. doi:10.1177/1534765608321070
10. C.R.Brewin,, B.Andrews,, & S.Rose, (2000). Fear, helplessness, and horror in posttraumatic stress disorder: Investigating DSM‐IV criterion A2 in victims of violent crime. Journal of Traumatic Stress, 13(3), 499–509. doi:10.1023/A:1007741526169
11. C.J.Bryan,, C.E.Morrow,, N.Etienne,, & B.Ray‐Sannerud, (2013). Guilt, shame, and suicidal ideation in a military outpatient clinical sample. Depression and Anxiety, 30(1), 55–60. doi:10.1002/da.22002
12. C.J.Bryan,, B.Ray-Sannerud,, C.E.Morrow,, & N.Etienne, (2013). Shame, pride, and suicidal ideation in a military clinical sample. Journal of Affective Disorders. 147(1–3), 212–216. doi:10.1016/j.jad.2012.11.006
13. R.L.Dearing,, J.Stuewig,, & J.P.Tangney, (2005). On the importance of distinguishing shame from guilt: Relations to problematic alcohol and drug use. Addictive Behaviors, 30(7), 1392–1404. doi:10.1016/j.addbeh.2005.02.002
14. K.D.Drescher,, D.W.Foy,, C.Kelly,, A.Leshner,, K.Schutz,, & B.Litz, (2011). An exploration of the viability and usefulness of the construct of moral injury in war veterans. Traumatology, 17(1), 8–13. doi:10.1177/1534765610395615
15. B.Engdahl,, T.N.Dikel,, R.Eberly,, & A.Blank Jr., (1997). Posttraumatic Stress Disorder in a community group of former prisoners of war: A normative response to severe trauma. American Journal of Psychiatry, 154(11), 1576–1581.
16. N.C.Feeny,, L.A.Zoellner,, & E.B.Foa, (2000). Anger, dissociation, and posttraumatic stress disorder among female assault victims. Journal of Traumatic Stress, 13(1), 89–100. doi:10.1023/A:1007725015225
17. D.Forbes,, M.Creamer,, G.Hawthorne,, N.Allen,, & T.McHugh, (2003). Comorbidity as a predictor of symptom change after treatment in combat-related posttraumatic stress disorder. Journal of Nervous and Mental Disease, 191(2), 93–99. doi:10.1097/01.NMD.0000051903.60517.98
18. P.Gilbert, (2000). Social mentalities: Internal ‘social’ conflicts & the role of inner-warmth & compassion in cognitive therapy. In P.Gilbert & K.G.Bailey (Eds.), Genes on the couch: Explorations in evolutionary psychotherapy. London, UK: Brunner-Routledge.
19. P.Gilbert,, & C.Irons, (2004). A pilot exploration of the use of compassionate images in a group of self‐critical people. Memory, 12(4), 507–516. doi:10.1080/09658210444000115
20. P.Gilbert,, J.Pehl,, & S.Allan, (1994). The phenomenology of shame and guilt: An empirical investigation. British Journal of Medical Psychology, 67(1), 23–36. doi:10.1111/papt.1994.67.issue-1
21. P.Gilbert,, & S.Procter, (2006). Compassionate mind training for people with high shame and self‐criticism: Overview and pilot study of a group therapy approach. Clinical Psychology & Psychotherapy, 13(6), 353–379. doi:10.1002/(ISSN)1099-0879
22. J.L.Goetz,, D.Keltner,, & E.Simon-Thomas, (2010). Compassion: An evolutionary analysis and empirical review. Psychological Bulletin, 136(3), 351–374. doi:10.1037/a0018807
23. M.J.Gray,, Y.Schorr,, W.Nash,, L.Lebowitz,, A.Amidon,, A.Lansing,, & B.T.Litz, (2012). Adaptive disclosure: An open trial of a novel exposure-based intervention for service members with combat-related psychological stress injuries. Behavior Therapy, 43(2), 407–415. doi:10.1016/j.beth.2011.09.001
24. L.M.Hathaway,, A.Boals,, & J.B.Banks, (2010). PTSD symptoms and dominant emotional response to a traumatic event: An examination of DSM-IV criterion A2. Anxiety, Stress & Coping, 23(1), 119–126. doi:10.1080/10615800902818771
25. N.E.Hundt,, & D.R.Holohan, (2012). The role of shame in distinguishing perpetrators of intimate partner violence in US veterans. Journal of Traumatic Stress, 25(2), 191–197. doi:10.1002/jts.v25.2
26. D.R.Johnson,, & H.Lubin, (2002). Effect of brief versus long-term inpatient treatment on homecoming stress in combat-related posttraumatic stress disorder: Three-year follow-up. The Journal of Nervous and Mental Disease, 190(1), 47–51.
27. D.R.Johnson,, H.Lubin,, R.Rosenheck,, A.Fontana,, S.Sonthwick,, & D.Charney, (1997). The impact of the homecoming reception on the development of posttraumatic stress disorder: The West Haven homecoming stress scale (WHHSS). Journal of Traumatic Stress, 10(2), 259–277. doi:10.1002/(ISSN)1573-6598
28. R.C.Kessler,, A.Sonnega,, E.Bromet,, M.Hughes,, & C.B.Nelson, (1995). Posttraumatic stress disorder in the national comorbidity survey. Archives of General Psychiatry, 52(12), 1048–1060. doi:10.1001/archpsyc.1995.03950240066012
29. S.Kim,, R.Thibodeau,, & R.S.Jorgensen, (2011). Shame, guilt, and depressive symptoms: A meta-analytic review. Psychological Bulletin, 137(1), 68–96. doi:10.1037/a0021466
30. R.A.Kulka,, W.E.Schlenger,, J.A.Fairbank,, R.L.Hough,, B.K.Jordan,, C.R.Marmar,, & D.S.Weiss, (1988). National Vietnam Veterans Readjustment Study (NVVRS): Description, current status, and initial PTSD prevalence estimates. Research Triangle Park, NC: Research Triangle Institute.
31. R.A.Kulka,, W.E.Schlenger,, J.A.Fairbank,, R.L.Hough,, B.K.Jordan,, C.R.Marmar,, & D.S.Weiss, (1990). Trauma and the Vietnam War generation: Report of findings from the National Vietnam veteran’s readjustments study. New York, NY: Brunner/Mazel.
32. R.A.Kulka,, W.E.Schlenger,, J.A.Fairbank,, B.K.Jordan,, R.L.Hough,, C.R.Marmar,, & D.S.Weiss, (1991). Assessment of posttraumatic stress disorder in the community: Prospects and pitfalls from recent studies of Vietnam veterans. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 3(4), 547–560.
33. R.A.Lanius,, R.Bluhm,, U.Lanius,, & C.Pain, (2006). A review of neuroimaging studies in PTSD: Heterogeneity of response to symptom provocation. Journal of Psychiatric Research, 40(8), 709–729. doi:10.1016/j.jpsychires.2005.07.007
34. J.Leskela,, M.Dieperink,, & P.Thuras, (2002). Shame and posttraumatic stress disorder. Journal of Traumatic Stress, 15(3), 223–226. doi:10.1023/A:1015255311837
35. B.T.Litz,, N.Stein,, E.Delaney,, L.Lebowitz,, W.P.Nash,, C.Silva,, & S.Maguen, (2009). Moral injury and moral repair in war veterans: A preliminary model and intervention strategy. Clinical Psychology Review, 29(8), 695–706. doi:10.1016/j.cpr.2009.07.003
36. A.Lutz,, J.Brefczynski-Lewis,, T.Johnstone,, & R.J.Davidson, (2008). Regulation of the neural circuitry of emotion by compassion meditation: Effects of meditative expertise. PLoS ONE, 3(3), e1897. doi:10.1371/journal.pone.0001897
37. J.W.Mason,, T.R.Kosten,, S.M.Southwick,, & E.L.Giller, (1990). The use of psychoendocrine strategies in post‐traumatic stress disorder. Journal of Applied Social Psychology, 20(21), 1822–1846. doi:10.1111/j.1559-1816.1990.tb01513.x
38. J.W.Mason,, S.Wang,, R.Yehuda,, S.Riney,, D.S.Charney,, & S.M.Southwick, (2001). Psychogenic lowering of urinary cortisol levels linked to increased emotional numbing and a shame-depressive syndrome in combat-related posttraumatic stress disorder. Psychosomatic Medicine, 63(3), 387–401. doi:10.1097/00006842-200105000-00008
39. L.McCormack,, & S.Joseph, (2013). Psychological growth in aging Vietnam veterans: Redefining shame and betrayal. Journal of Humanistic Psychology. 54(3), 336–355. doi:10.1177/0022167813501393
40. M.McFall,, A.Fontana,, M.Raskind,, & R.Rosenheck, (1999). Analysis of violent behavior in Vietnam combat veteran psychiatric inpatients with posttraumatic stress disorder. Journal of Traumatic Stress, 12(3), 501–517. doi:10.1023/A:1024771121189
41. Mental Health Advisory Team (MHAT-V). (2008a, February 14). Operation Enduring Freedom 8: Afghanistan. Retrieved from http://www.armymedicine.army.mil/reports/mhat/mhat_v/mhat-v.cfm
42. Mental Health Advisory Team (MHAT-V). (2008b, February 14). Operation Iraqi Freedom 06-08: Iraq. Retrieved from http://www.armymedicine.army.mil/reports/mhat/mhat_v/mhat-v.cfm
43. S.M.Orsillo,, R.G.Heimberg,, H.R.Juster,, & J.Garrett, (1996). Social phobia and PTSD in Vietnam veterans. Journal of Traumatic Stress, 9(2), 235–252. doi:10.1002/(ISSN)1573-6598
44. U.Orth,, & E.Wieland, (2006). Anger, hostility, and posttraumatic stress disorder in trauma-exposed adults: A meta-analysis. Journal of Consulting and Clinical Psychology, 74(4), 698–706. doi:10.1037/0022-006X.74.4.698
45. R.T.Potter-Efron, (1989). Shame, guilt, and alcoholism: Treatment issues in clinical practice. New York, NY: Haworth Press.
46. R.Ramchand,, J.Acosta,, & R.M.Burns, (2011). War within: Preventing suicide in the US military. San Monica, CA: Rand Corporation.
47. A.R.Rangganadhan,, & N.Todorov, (2010). Personality and self-forgiveness: The roles of shame, guilt, empathy and conciliatory behavior. Journal of Social and Clinical Psychology, 29(1), 1–22. doi:10.1521/jscp.2010.29.1.1
48. N.A.Rector,, R.M.Bagby,, Z.V.Segal,, R.T.Joffe,, & A.Levitt, (2000). Self-criticism and dependency in depressed patients treated with cognitive therapy or pharmacotherapy. Cognitive Therapy and Research, 24(5), 571–584. doi:10.1023/A:1005566112869
49. D.J.Robinaugh,, & R.J.McNally, (2010). Autobiographical memory for shame or guilt provoking events: Association with psychological symptoms. Behaviour Research and Therapy, 48(7), 646–652. doi:10.1016/j.brat.2010.03.017
50. K.H.Seal,, T.J.Metzler,, K.S.Gima,, D.Bertenthal,, S.Maguen,, & C.R.Marmar, (2009). Trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans using Department of Veterans Affairs health care, 2002–2008. American Journal of Public Health, 99(9), 1651–1658. doi:10.2105/AJPH.2008.150284.
51. N.R.Stein,, M.A.Mills,, K.Arditte,, C.Mendoza,, A.M.Borah,, P.A.Resick,, & E.Wright, (2012). Scheme for categorizing traumatic military events. Behavior Modification, 36(6), 787–807. doi:10.1177/0145445512446945
52. C.T.Taft,, D.G.Kaloupek,, J.A.Schumm,, A.D.Marshall,, J.Panuzio,, D.W.King,, & T.M.Keane, (2007). Posttraumatic stress disorder symptoms, physiological reactivity, alcohol problems, and aggression among military veterans. Journal of Abnormal Psychology, 116(3), 498–507. doi:10.1037/0021-843X.116.3.498
53. J.P.Tangney,, R.S.Miller,, L.Flicker,, & D.H.Barlow, (1996). Are shame, guilt, and embarrassment distinct emotions? Journal of Personality and Social Psychology, 70, 1256–1269. doi:10.1037/0022-3514.70.6.1256
54. F.Teroni,, & O.Bruun, (2011). Shame, guilt and morality. Journal of Moral Philosophy, 8(2), 223–245. doi:10.1163/174552411X563574
55. N.T.Van Dam,, S.C.Sheppard,, J.P.Forsyth,, & M.Earleywine, (2011). Self-compassion is a better predictor than mindfulness of symptom severity and quality of life in mixed anxiety and depression. Journal of Anxiety Disorders, 25(1), 123–130. doi:10.1016/j.janxdis.2010.08.011
56. K.J.Van Vliet, (2010). Shame and avoidance in trauma. In E.Martz (Ed.), Trauma rehabilitation after war and conflict (pp. 247–263). New York, NY: Springer.
57. A.F.Vargas,, T.Hanson,, D.Kraus,, K.Drescher,, & D.Foy, (2013). Moral injury themes in combat veterans’ narrative responses from the national Vietnam veterans’ readjustment study. Traumatology, 19(3), 243–250. doi:10.1177/1534765613476099
58. B.A.Vellenga,, & J.Christenson, (1995). Healing the wounds of war: The Vietnam veteran after operation desert storm. Perspectives in Psychiatric Care, 31(4), 5–8. doi:10.1111/j.1744-6163.1995.tb00480.x
59. J.P.Wilson,, B.Droždek,, & S.Turkovic, (2006). Posttraumatic shame and guilt. Trauma, Violence, & Abuse, 7(2), 122–141. doi:10.1177/1524838005285914
60. M.R.Wong,, & D.Cook, (1992). Shame and its contribution to PTSD. Journal of Traumatic Stress, 5(4), 557–562. doi:10.1002/(ISSN)1573-6598.