Scholars@Duke publication: A model comparison approach to trauma-related guilt as a mediator of the relationship between PTSD symptoms and suicidal ideation among veterans.

A model comparison approach to trauma-related guilt as a mediator of the relationship between PTSD symptoms and suicidal ideation among veterans.

Publication , Journal Article

Cunningham, KC; Farmer, C; LoSavio, ST; Dennis, PA; Clancy, CP; Hertzberg, MA; Collie, CF; Calhoun, PS; Beckham, JC

Published in: J Affect Disord

October 15, 2017

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.

Duke Scholars

Author Paul Anthony Dennis Population Health Sciences

Author Michael Andrew Hertzberg Psychiatry & Behavioral Sciences, Adult Psychiatry & Psychol ...

Author Patrick Shields Calhoun Psychiatry & Behavioral Sciences, Behavioral Medicine & Neur ...

Author Jean Crowell Beckham Psychiatry & Behavioral Sciences, Behavioral Medicine & Neur ...

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Published In

J Affect Disord

DOI

10.1016/j.jad.2017.06.046

EISSN

1573-2517

Publication Date

October 15, 2017

Volume

221

Start / End Page

227 / 231

Location

Netherlands

Related Subject Headings

Veterans
Suicidal Ideation
Stress Disorders, Post-Traumatic
Psychiatry
Models, Psychological
Middle Aged
Male
Humans
Guilt
Female

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APA

Chicago

ICMJE

MLA

NLM

Cunningham, K. C., Farmer, C., LoSavio, S. T., Dennis, P. A., Clancy, C. P., Hertzberg, M. A., … Beckham, J. C. (2017). A model comparison approach to trauma-related guilt as a mediator of the relationship between PTSD symptoms and suicidal ideation among veterans. J Affect Disord, 221, 227–231. https://doi.org/10.1016/j.jad.2017.06.046

Cunningham, Katherine C., Chloe Farmer, Stefanie T. LoSavio, Paul A. Dennis, Carolina P. Clancy, Michael A. Hertzberg, Claire F. Collie, Patrick S. Calhoun, and Jean C. Beckham. “A model comparison approach to trauma-related guilt as a mediator of the relationship between PTSD symptoms and suicidal ideation among veterans.” J Affect Disord 221 (October 15, 2017): 227–31. https://doi.org/10.1016/j.jad.2017.06.046.

Cunningham KC, Farmer C, LoSavio ST, Dennis PA, Clancy CP, Hertzberg MA, et al. A model comparison approach to trauma-related guilt as a mediator of the relationship between PTSD symptoms and suicidal ideation among veterans. J Affect Disord. 2017 Oct 15;221:227–31.

Cunningham, Katherine C., et al. “A model comparison approach to trauma-related guilt as a mediator of the relationship between PTSD symptoms and suicidal ideation among veterans.” J Affect Disord, vol. 221, Oct. 2017, pp. 227–31. Pubmed, doi:10.1016/j.jad.2017.06.046.

Cunningham KC, Farmer C, LoSavio ST, Dennis PA, Clancy CP, Hertzberg MA, Collie CF, Calhoun PS, Beckham JC. A model comparison approach to trauma-related guilt as a mediator of the relationship between PTSD symptoms and suicidal ideation among veterans. J Affect Disord. 2017 Oct 15;221:227–231.