Posttraumatic shame and guilt.

Posttraumatic shame and guilt are important dimensions of posttraumatic syndromes, including simple and complex post-traumatic stress disorder (PTSD). The concepts of posttraumatic shame and guilt have received little theoretical or empirical investigation in the field of traumatology. It is proposed that there are acute and prolonged states of posttraumatic shame and guilt that can be compared in their consequences across eight psychosocial dimensions: (a) self-attribution processes, (b) emotional states and capacity for affect regulation, (c) appraisal and interpretation of actions, (d) the impact of states of shame and guilt on personal identity, (e) suicidality, (f) defensive patterns, (g) proneness to psychopathology and PTSD, and (h) the dimensions of the self-structure adversely affected by states of posttraumatic shame and guilt. The experience of posttraumatic states of shame and guilt are associated with compounded affective processes in PTSD, depression, and substance use disorders.