Harvard University, USA.
Behav Res Ther. 2010 Jul;48(7):646-52. doi: 10.1016/j.brat.2010.03.017. Epub 2010 Mar 27.
The diagnostic criteria for posttraumatic stress disorder (PTSD) specify that a qualifying traumatic stressor must incite extreme peritraumatic fear, horror, or helplessness. However, research suggests that events inciting guilt or shame may be associated with PTSD. We devised a web-based survey in which non-clinical participants identified an event associated with shame or guilt and completed questionnaire measures of shame, guilt, PTSD, and depression. In addition, we assessed characteristics of memory for the event, including visual perspective and the centrality of the memory to the participant's autobiographical narrative (CES). Shame predicted depression and PTSD symptoms. There was no association between guilt and psychological symptoms after controlling statistically for the effects of shame. CES predicted the severity of depression and PTSD symptoms. In addition, CES mediated the moderating effect of visual perspective on the relationship between emotional intensity and PTSD symptoms. Our results suggest shame is capable of eliciting the intrusive and distressing memories characteristic of PTSD. Furthermore, our results suggest aversive emotional events are associated with psychological distress when memory for those events becomes central to one's identity and autobiographical narrative.
创伤后应激障碍(PTSD)的诊断标准规定,合格的创伤性应激源必须引起极度的创伤前恐惧、恐惧或无助。然而,研究表明,引发内疚或羞耻感的事件可能与 PTSD 有关。我们设计了一个基于网络的调查,其中非临床参与者确定一个与羞耻或内疚有关的事件,并完成了羞耻、内疚、PTSD 和抑郁的问卷测量。此外,我们评估了对事件的记忆特征,包括视觉视角和记忆对参与者自传体叙述的中心性(CES)。羞耻感预测抑郁和 PTSD 症状。在控制了羞耻感的影响后,内疚与心理症状之间没有关联。CES 预测了抑郁和 PTSD 症状的严重程度。此外,CES 介导了视觉视角对情绪强度与 PTSD 症状之间关系的调节作用。我们的研究结果表明,羞耻感能够引发 PTSD 所特有的侵入性和痛苦记忆。此外,我们的研究结果表明,当一个人对这些事件的记忆成为其身份和自传体叙述的核心时,令人不快的情绪事件与心理困扰有关。