Katherine C Cunningham1, Chloe Farmer2, Stefanie T LoSavio2, Paul A Dennis2, Carolina P Clancy3, Michael A Hertzberg4, Claire F Collie4, Patrick S Calhoun4, Jean C Beckham4. 1. Durham Veterans Affairs Medical Center, Durham, NC, USA; The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA. Electronic address: katherine-cunningham@utulsa.ed. 2. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA. 3. Durham Veterans Affairs Medical Center, Durham, NC, USA. 4. Durham Veterans Affairs Medical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
Abstract
BACKGROUND: Suicidal ideation (SI) is a serious issue affecting U.S. veterans, and those with posttraumatic stress disorder (PTSD) are at an especially high risk of SI. Guilt has been associated with both PTSD and SI and may therefore be an important link between these constructs. METHODS: The present study compared models of trauma-related guilt and used path analysis to examine the direct and indirect effects of PTSD and trauma-related guilt on SI among a sample of 988 veterans receiving outpatient PTSD treatment at a Veterans Affairs (VA) specialty clinic. RESULTS: Results showed that a model of trauma-related guilt including guilt-cognitions and global guilt (but not distress) provided the best model fit for the data. PTSD and trauma-related guilt had direct effects on SI, and PTSD exhibited indirect effects on SI via trauma-related guilt. LIMITATIONS: The use of cross-sectional data limits the ability to make causal inferences. A treatment-seeking sample composed primarily of Vietnam veterans limits generalizability to other populations. CONCLUSIONS: Trauma-related guilt, particularly guilt cognitions, may be an effective point of intervention to help reduce SI among veterans with PTSD. This is an important area of inquiry, and suggestions for future research are discussed. Published by Elsevier B.V.
BACKGROUND: Suicidal ideation (SI) is a serious issue affecting U.S. veterans, and those with posttraumatic stress disorder (PTSD) are at an especially high risk of SI. Guilt has been associated with both PTSD and SI and may therefore be an important link between these constructs. METHODS: The present study compared models of trauma-related guilt and used path analysis to examine the direct and indirect effects of PTSD and trauma-related guilt on SI among a sample of 988 veterans receiving outpatientPTSD treatment at a Veterans Affairs (VA) specialty clinic. RESULTS: Results showed that a model of trauma-related guilt including guilt-cognitions and global guilt (but not distress) provided the best model fit for the data. PTSD and trauma-related guilt had direct effects on SI, and PTSD exhibited indirect effects on SI via trauma-related guilt. LIMITATIONS: The use of cross-sectional data limits the ability to make causal inferences. A treatment-seeking sample composed primarily of Vietnam veterans limits generalizability to other populations. CONCLUSIONS:Trauma-related guilt, particularly guilt cognitions, may be an effective point of intervention to help reduce SI among veterans with PTSD. This is an important area of inquiry, and suggestions for future research are discussed. Published by Elsevier B.V.
Authors: Maurizio Pompili; Leo Sher; Gianluca Serafini; Alberto Forte; Marco Innamorati; Giovanni Dominici; David Lester; Mario Amore; Paolo Girardi Journal: J Nerv Ment Dis Date: 2013-09 Impact factor: 2.254
Authors: Noelle B Smith; Natalie Mota; Jack Tsai; Lindsey Monteith; Ilan Harpaz-Rotem; Steven M Southwick; Robert H Pietrzak Journal: J Affect Disord Date: 2016-03-02 Impact factor: 4.839
Authors: Katherine A Dondanville; Abby E Blankenship; Alma Molino; Patricia A Resick; Jennifer Schuster Wachen; Jim Mintz; Jeffrey S Yarvis; Brett T Litz; Elisa V Borah; John D Roache; Stacey Young-McCaughan; Elizabeth A Hembree; Alan L Peterson Journal: Behav Res Ther Date: 2016-02-04
Authors: Craig J Bryan; Tracy A Clemans; Ann Marie Hernandez; Jim Mintz; Alan L Peterson; Jeffrey S Yarvis; Patricia A Resick Journal: Depress Anxiety Date: 2015-12-04 Impact factor: 6.505
Authors: Kirsten H Dillon; Katherine C Cunningham; Julia M Neal; Sarah M Wilson; Eric A Dedert; Eric B Elbogen; Patrick S Calhoun; Jean C Beckham; Nathan A Kimbrel Journal: J Affect Disord Date: 2018-04-11 Impact factor: 4.839
Authors: Katherine C Cunningham; Frances M Aunon; Tapan A Patel; Adam J Mann; Bryann B DeBeer; Eric C Meyer; Sandra B Morissette; Paul J Silvia; Kim L Gratz; Patrick S Calhoun; Jean C Beckham; Nathan A Kimbrel Journal: J Affect Disord Date: 2021-03-15 Impact factor: 4.839