The association between posttraumatic stress disorder and trauma-related guilt, shame, fear, and sense of control in women with sexual trauma

Peri-trauma emotional reactions and sense of control have been shown to be important predictors of post-traumatic stress disorder (PTSD) in various groups of trauma survivors. It is not clear how these reactions exert their impact on PTSD. One hypothesis could be that post-trauma fear due to an ongoing sense to threat to safety and sense of helplessness in life, trauma-related shame and guilt cognitions mediate the association between peri-trauma reactions and PTSD. These post-trauma reactions have been reported to be associated with PTSD. The present study examined these associations using structural equation modeling (SEM) in sexual trauma survivors. Data from 601 women with sexual trauma history were collected using the Facebook advertisement tool. Survivors completed online versions of Trauma-Related Guilt Inventory, Trauma-Related Shame Inventory, Fear and Loss of Control Scale and Traumatic Stress Symptom Checklist and rated their peri-trauma fear / distress / discomfort and sense of control. Both the measurement model and the structural model provided an acceptable fit. The findings provided support to the hypothesis that the relationship between PTSD symptom severity and peri-trauma distress and sense of control is mediated through post-trauma fear and helplessness responses and trauma-related shame but did not support the mediatory role of guilt cognitions. These findings highlight the important role played by post-trauma emotional reactions in traumatic stress and suggest that effective psychological interventions aimed at reducing fear and shame and enhancing sense of control over one's life would be effective in improving traumatic stress symptoms in survivors of sexual trauma.