What will others think of me? The longitudinal association between trauma-related shame and guilt and psychopathology after a terror attack
Background Trauma-related shame and guilt have been identified as important factors for mental health following interpersonal trauma. For survivors of terror and disasters, however, the role of shame and guilt remains largely unknown. Aims To explore the long-term occurrence of trauma-related shame...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2024-01-01
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| Series: | BJPsych Open |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472423006245/type/journal_article |
| _version_ | 1797357502505943040 |
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| author | Kristin Alve Glad Helene Flood Aakvaag Tore Wentzel-Larsen Grete Dyb Siri Thoresen |
| author_facet | Kristin Alve Glad Helene Flood Aakvaag Tore Wentzel-Larsen Grete Dyb Siri Thoresen |
| author_sort | Kristin Alve Glad |
| collection | DOAJ |
| description | Background
Trauma-related shame and guilt have been identified as important factors for mental health following interpersonal trauma. For survivors of terror and disasters, however, the role of shame and guilt remains largely unknown.
Aims
To explore the long-term occurrence of trauma-related shame and guilt among survivors of a terror attack, and the potential importance of these emotions for mental health.
Method
A total of 347 survivors (48.7% female, mean age at the time of the attack: 19.25 years, s.d. = 4.40) of the 2011 massacre on Utøya island, Norway, participated in face-to-face, semi-structured interviews. Trauma-related shame and guilt were measured with items from the Shame and Guilt After Trauma Scale at 2.5 and 8.5 years post-terror attack. Post-traumatic reactions and anxiety/depression at 8.5 years post-terror attack were measured with the University of California at Los Angeles PTSD Reaction Index and the Hopkins Symptom Checklist-25, respectively. Associations between trauma-related shame/guilt and post-trauma psychopathology were analysed by multiple linear regressions.
Results
Trauma-related shame and guilt were prevalent among survivors at both 2.5 and 8.5 years post-terror attack. In unadjusted analyses, shame and guilt, at both time points, were significantly associated with post-traumatic stress reactions and anxiety/depression. Shame remained significantly associated with mental health when adjusted for guilt. Both earlier and current shame were uniquely related to mental health.
Conclusions
Trauma-related shame and guilt may be prevalent in survivors of mass trauma several years after the event. Shame, in particular, may play an important role for long-term mental health. Clinicians may find it helpful to explicitly address shame in treatment of mass trauma survivors.
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| first_indexed | 2024-03-08T14:46:04Z |
| format | Article |
| id | doaj.art-7f68d2f62f8f44c0be6b6630ae936664 |
| institution | Directory Open Access Journal |
| issn | 2056-4724 |
| language | English |
| last_indexed | 2024-03-08T14:46:04Z |
| publishDate | 2024-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj.art-7f68d2f62f8f44c0be6b6630ae9366642024-01-11T09:16:21ZengCambridge University PressBJPsych Open2056-47242024-01-011010.1192/bjo.2023.624What will others think of me? The longitudinal association between trauma-related shame and guilt and psychopathology after a terror attackKristin Alve Glad0https://orcid.org/0000-0002-9965-8595Helene Flood Aakvaag1Tore Wentzel-Larsen2Grete Dyb3Siri Thoresen4https://orcid.org/0000-0001-5688-7948Division for Disasters, Terror and Stress Management, Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, NorwayDivision for Disasters, Terror and Stress Management, Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, NorwayDivision for Disasters, Terror and Stress Management, Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway; and Division for Service Research and Innovation, Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, NorwayDivision for Disasters, Terror and Stress Management, Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway; and Institute of Clinical Medicine, University of Oslo, NorwayDivision for Disasters, Terror and Stress Management, Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway; and Department of Psychology, University of Oslo, NorwayBackground Trauma-related shame and guilt have been identified as important factors for mental health following interpersonal trauma. For survivors of terror and disasters, however, the role of shame and guilt remains largely unknown. Aims To explore the long-term occurrence of trauma-related shame and guilt among survivors of a terror attack, and the potential importance of these emotions for mental health. Method A total of 347 survivors (48.7% female, mean age at the time of the attack: 19.25 years, s.d. = 4.40) of the 2011 massacre on Utøya island, Norway, participated in face-to-face, semi-structured interviews. Trauma-related shame and guilt were measured with items from the Shame and Guilt After Trauma Scale at 2.5 and 8.5 years post-terror attack. Post-traumatic reactions and anxiety/depression at 8.5 years post-terror attack were measured with the University of California at Los Angeles PTSD Reaction Index and the Hopkins Symptom Checklist-25, respectively. Associations between trauma-related shame/guilt and post-trauma psychopathology were analysed by multiple linear regressions. Results Trauma-related shame and guilt were prevalent among survivors at both 2.5 and 8.5 years post-terror attack. In unadjusted analyses, shame and guilt, at both time points, were significantly associated with post-traumatic stress reactions and anxiety/depression. Shame remained significantly associated with mental health when adjusted for guilt. Both earlier and current shame were uniquely related to mental health. Conclusions Trauma-related shame and guilt may be prevalent in survivors of mass trauma several years after the event. Shame, in particular, may play an important role for long-term mental health. Clinicians may find it helpful to explicitly address shame in treatment of mass trauma survivors. https://www.cambridge.org/core/product/identifier/S2056472423006245/type/journal_articleMass traumashameguiltpost-traumatic stress disordermental health |
| spellingShingle | Kristin Alve Glad Helene Flood Aakvaag Tore Wentzel-Larsen Grete Dyb Siri Thoresen What will others think of me? The longitudinal association between trauma-related shame and guilt and psychopathology after a terror attack BJPsych Open Mass trauma shame guilt post-traumatic stress disorder mental health |
| title | What will others think of me? The longitudinal association between trauma-related shame and guilt and psychopathology after a terror attack |
| title_full | What will others think of me? The longitudinal association between trauma-related shame and guilt and psychopathology after a terror attack |
| title_fullStr | What will others think of me? The longitudinal association between trauma-related shame and guilt and psychopathology after a terror attack |
| title_full_unstemmed | What will others think of me? The longitudinal association between trauma-related shame and guilt and psychopathology after a terror attack |
| title_short | What will others think of me? The longitudinal association between trauma-related shame and guilt and psychopathology after a terror attack |
| title_sort | what will others think of me the longitudinal association between trauma related shame and guilt and psychopathology after a terror attack |
| topic | Mass trauma shame guilt post-traumatic stress disorder mental health |
| url | https://www.cambridge.org/core/product/identifier/S2056472423006245/type/journal_article |
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