Survivor’s Guilt Can Increase Risks for PTSD

New evidence from an American research team indicates that people who feel guilty in the aftermath of highly traumatic situations may have increased odds of developing PTSD. Some people who live through dangerous or potentially fatal situations experience feelings known collectively as survivor’s guilt or post-traumatic guilt. In a study published in April 2015 in the Journal of Traumatic Stress, researchers from seven U.S. institutions assessed the role that post-traumatic guilt may play in the onset of post-traumatic stress disorder (PTSD) in the aftermath of trauma exposure. These researchers concluded that survivor’s guilt may indirectly increase the risks for PTSD by interacting with any given person’s level of general psychological distress.

Post-Traumatic Guilt

Traumatic situations and events get their name because they temporarily overwhelm the innate human capacity to adjust to changing circumstances while maintaining a sense of mental/emotional equilibrium. The worst of these events and situations make a person fear for his or her life, or for the lives of others. Specific examples of highly traumatic circumstances include natural disasters, physical assaults, direct combat exposure, witnessing of combat, direct terrorism exposure, witnessing of acts of terror, sexual assaults, major injuries and severe illnesses. Most people bounce back fairly quickly from trauma exposure. However, significant numbers of people develop a dysfunctional short-term reaction known as acute stress disorder or ASD. A longer-term dysfunctional reaction to traumatic events and situations, PTSD, is only diagnosable in people who have ASD symptoms that last for more than a month, or in people who only develop symptoms after the one-month window for an ASD diagnosis has closed. Post-traumatic guilt is not necessarily associated with acute stress disorder or post-traumatic stress disorder. Psychologists and psychiatrists use the term to describe the tendency to belatedly make negative judgments on one’s behavior during traumatic circumstances, as well as the tendency to feel bad for living through traumatic circumstances when other people sustain serious injuries or die. People who retroactively misjudge their capacity to alter a traumatic event or situation may irrationally come to blame themselves for what transpired.

General Psychological Distress

Your level of general psychological distress is a combined assessment of your current state of mental/emotional well-being. People with low levels of distress typically feel good and are psychologically well-adjusted. Conversely, people with high levels of distress may experience problems with a range of issues, including such things as feelings of guilt, anxiety-related feelings, depression-related feelings, sleeping problems, appetite disruptions, fatigue, outbursts of anger and dysfunctional thought processes that don’t respond to normal attempts at self-restraint or self-control. Broadly speaking, a person with high levels of general psychological distress has increased chances of developing substance-related problems, as well as mental illnesses that trigger suicidal or self-harming behaviors.

Impact on PTSD Risks

In the study published in the Journal of Traumatic Stress, researchers from institutions including the VA Puget Sound Healthcare System, the University of Washington, the University of California San Diego and the National Center for PTSD used a project involving 149 male veterans of military service in Afghanistan or Iraq to help uncover the mental health impact of post-traumatic guilt. Specifically, the researchers wanted to test a previously established theory on the connection between post-traumatic guilt, trauma-related memory, general psychological distress and physical distress. In addition, the researchers wanted to know how these factors impact any given individual’s chances of developing PTSD. The researchers concluded that there is an indirect link between a person’s baseline tendencies toward guilty thought and the chances of experiencing post-traumatic guilt. They also concluded that the link between these two factors is physical and general psychological distress. In the context of PTSD, the presence of psychological and physical distress may act as one of the primary determinants of the odds of developing the disorder. Feelings of distress may also act as one of the primary determinants of trauma-related depression. Critically, the researchers concluded that guilty feelings in the individual may increase the likelihood that a person affected by psychological and physical distress will go on to develop PTSD. The study’s authors note that they could not separate distress specifically associated with guilty thinking/post-traumatic guilt from distress associated more generally with the memories of traumatic events or situations. They point toward a need for future research in order to clarify the difference between these two issues.

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