Publication year
2015
Citation Title
Exposure, agency, perceived threat, and guilt as predictors of posttraumatic stress disorder in veterans.
Journal Name
Journal of Counseling & Development
Journal Volume
93
Issue Number
1
Page Numbers
3-13
DOI
10.1002/j.1556-6676.2015.00176.x
Summary
Online survey data from Iraq and Afghanistan Veterans was used to assess the relationship between posttraumatic stress disorder (PTSD) and four constructs: combat exposure, perceived threat during combat, causing harm during combat, and combat-related guilt. These four constructs accounted for the majority of differences in PTSD symptoms. A variety of demographic factors were associated with with four constructs explored and PTSD symptom.
Key Findings
Forty-three percent of the participating Veterans had probable PTSD.
Low rank, being Black, and serving in the Guard forces were positively related to combat exposure, perceived threat during combat, causing harm during combat, guilt, and PTSD symptoms.
Coupled with demographic characteristics, combat exposure, perceived threat during combat, causing harm during combat, and guilt accounted for 79% of observed variance in PTSD symptoms.
When Service members reported guilt, along with exposure, perceived threat during combat, or causing harm during combat, they were more likely to report high PTSD symptom severity.
Implications for Program Leaders
Train Service members to re-assess war-zone experiences that may give rise to feelings of guilt, considering their level of choice in the situation
Offer classes for Veterans’ friends and families to help them identify feelings of guilt in Veterans and support help-seeking
Provide training to Service members in relaxation techniques following deployment
Implications for Policy Makers
Encourage installations to implement campaigns highlighting beneficial outcomes of United States involvement in overseas conflict
Recommend continuing education for mental health practitioners on identifying common causes of guilt and healthy coping resources
Suggest screenings for Service members following deployment that includes assessment of both direct combat exposure and the aftermath of conflict
Methods
Participants were recruited through National Veteran Organization Facebook pages and university Student Veteran Organizations.
Participants completed an online survey.
The survey assessed four constructs: combat exposure (exposure to combat, aftermath of combat, and atrocity exposure), perceived threat (fear for one’s own safety in the war-zone), guilt (cognitive and emotional appraisals related to traumatic war-zone events) and agency (combat participation that causes harm to others).
Participants
Participants included 289 Iraq and Afghanistan Veterans.
Veterans were from the Army (46%), Marines (20%), Navy (10%), and Air Force (8%).
Respondents reported an average age of 30 years (SD = 8 years, range = 19-60), and were predominantly White (66%).
Fifty-four percent of respondents were deployed once, 30% were deployed twice, and 14% were deployed three or more times.
Limitations
The study excluded participants who reported suicidal ideation in the past three months which may have biased the findings.
Participants were recruited from existing peer groups and may not be reflective of the general Veteran population.
The survey was hosted online and may have excluded those without regular Internet access.
Avenues for Future Research
Examine both the negative and possible positive correlates of guilt in behavioral self-monitoring
Explore the role of group cohesion in predicting guilt
Disaggregate general guilt, guilt resulting from inaction, and guilt resulting from negative actions, and the implications of each for PTSD
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
Using a sample of 289 Iraq/Afghanistan veterans, this study examined the contributions of combat exposure, agency, perceived threat, and guilt to posttraumatic stress disorder (PTSD) symptoms. Regression analyses indicated the four variables (together with demographic variables) accounted for 79% of the variance in PTSD symptoms. Guilt was the most important predictor. In addition, guilt mediated between exposure and PTSD symptoms, perceived threat and PTSD symptoms, and agency and PTSD symptoms. Implications of these findings are discussed. Using a sample of 289 Iraq/Afghanistan veterans, this study examined the contributions of combat exposure, agency, perceived threat, and guilt to posttraumatic stress disorder (PTSD) symptoms. Regression analyses indicated the four variables (together with demographic variables) accounted for 79% of the variance in PTSD symptoms. Guilt was the most important predictor. In addition, guilt mediated between exposure and PTSD symptoms, perceived threat and PTSD symptoms, and agency and PTSD symptoms. Implications of these findings are discussed.
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