Posttraumatic survivor guilt is associated with white matter microstructure alterations.

BACKGROUND: Military veterans with posttraumatic stress disorder (PTSD) commonly experience posttraumatic guilt. Guilt over commission or omission evolves when responsibility is assumed for an unfortunate outcome (e.g., the death of a fellow combatant). Survivor guilt is a state of intense emotional distress experienced by the weight of knowing that one survived while others did not. METHODS: This study of the Translational Research Center for TBI and Stress Disorders (TRACTS) analyzed structural and diffusion-weighted magnetic resonance imaging data from 132 male Iraq/Afghanistan veterans with PTSD. The Clinician-Administered PTSD Scale for DSM-IV (CAPS-IV) was employed to classify guilt. Thirty (22.7 %) veterans experienced guilt over acts of commission or omission, 34 (25.8 %) experienced survivor guilt, and 68 (51.5 %) had no posttraumatic guilt. White matter microstructure (fractional anisotropy, FA), cortical thickness, and cortical volume were compared between veterans with guilt over acts of commission or omission, veterans with survivor guilt, and veterans without guilt. RESULTS: Veterans with survivor guilt had significantly lower white matter FA compared to veterans who did not experience guilt (p < .001), affecting several regions of major white matter fiber bundles. There were no significant differences in white matter FA, cortical thickness, or volumes between veterans with guilt over acts of commission or omission and veterans without guilt (p > .050). LIMITATIONS: This cross-sectional study with exclusively male veterans precludes inferences of causality between the studied variables and generalizability to the larger veteran population that includes women. CONCLUSION: Survivor guilt may be a particularly impactful form of posttraumatic guilt that requires specific treatment efforts targeting brain health.

The nonverbal expression of guilt in healthy adults.

Guilt is a negative emotion elicited by realizing one has caused actual or perceived harm to another person. One of guilt's primary functions is to signal that one is aware of the harm that was caused and regrets it, an indication that the harm will not be repeated. Verbal expressions of guilt are often deemed insufficient by observers when not accompanied by nonverbal signals such as facial expression, gesture, posture, or gaze. Some research has investigated isolated nonverbal expressions in guilt, however none to date has explored multiple nonverbal channels simultaneously. This study explored facial expression, gesture, posture, and gaze during the real-time experience of guilt when response demands are minimal. Healthy adults completed a novel task involving watching videos designed to elicit guilt, as well as comparison emotions. During the video task, participants were continuously recorded to capture nonverbal behaviour, which was then analyzed via automated facial expression software. We found that while feeling guilt, individuals engaged less in several nonverbal behaviours than they did while experiencing the comparison emotions. This may reflect the highly social aspect of guilt, suggesting that an audience is required to prompt a guilt display, or may suggest that guilt does not have clear nonverbal correlates.

Person-specific dynamics between negative emotions and suicidal thoughts.

INTRODUCTION: Recent technology has enabled researchers to collect ecological momentary assessments (EMA) to examine within-person correlates of suicidal thoughts. Prior studies examined generalized temporal dynamics of emotions and suicidal thinking over brief periods, but it is not yet known how variable these processes are across people. METHOD: We use data EMA data delivered over two weeks with youth/young adults (N = 60) who reported past year self-injurious thoughts/behaviors. We used group iterative multiple model estimation (GIMME) to model group- and person-specific associations of negative emotions (i.e., fear, sadness, shame, guilt, and anger) and suicidal thoughts. RESULTS: 29 participants (48.33%) reported at least one instance of a suicidal thought and were included in GIMME models. In group level models, we consistently observed autoregressive effects for suicidal thoughts (e.g., earlier thoughts predicting later thoughts), although the magnitude and direction of this link varied from person-to-person. Among emotions, sadness was most frequently associated with contemporaneous suicidal thoughts, but this was evident for less than half of the sample, while other emotional correlates of suicidal thoughts broadly differed across people. No emotion variable was linked to future suicidal thoughts in >14% of the sample, CONCLUSIONS: Emotion-based correlates of suicidal thoughts are heterogeneous across people. Better understanding of the individual-level pathways maintaining suicidal thoughts/behaviors may lead to more effective, personalized interventions.

The perceived guilt and innocence of adults with developmental language disorder and adults with typical language during a mock interrogation.

PURPOSE: This study examined if there were differences in the guilty and not guilty judgments of adults with developmental language disorder (DLD) and those with typical language (TL) functioning. METHOD: Twenty-four adults (12 DLD, 12 TL) were assigned to either the guilty or not guilty conditions. Those in the guilty condition engaged in a mock crime while those in the not guilty condition were informed that a crime had been committed. Peer jurors were presented with video interrogations of the DLD (6 guilty, 6 not guilty) and TL (6 guilty, 6 not guilty) participants and were asked to make categorical judgments of guilty and not guilty and to indicate confidence in their judgments. RESULTS: In general, peer jurors were not accurate in their judgments of the accused, and were more likely to judge individuals with DLD as guilty relative to accused individuals with TL. Peer jurors were particularly poor at judging innocent adults with DLD as not guilty and guilty adults with TL as guilty. Despite this, peer jurors were more confident than not in their guilty and not guilty determinations. CONCLUSIONS: Peer jurors are confident in their judgments of the guilt of the accused when they should not be, particularly in the case of accused adults with DLD. Implications are discussed.

Vortex of regret: How positive and negative coping strategies correlate with feelings of guilt.

Bad coping behavior and guilt may reinforce each other as a negative feedback loop. Social contexts and expectations may also create cognitive dissonance in coping individuals and affect the effectiveness of coping styles. This study examines the associations between the feeling of guilt and specific coping styles belonging to both groups of positive and negative coping styles. We conducted Bayesian Multiple Regression analyses on secondary data from 3784 high school students in China. Positive coping is associated more with reduced feelings of guilt compared to negative coping. However, some positive coping styles were found to be positively associated with a sense of guilt, especially those involving confrontation against or conformity to social expectations. Most negative coping styles are positively associated with guilt, and substance use has the strongest influence among the examined negative coping styles. The findings suggest that the consideration of sociocultural contexts is very important in supporting those with guilt issues, especially adolescents in societies with dominant traditional East Asian values.

Perceived stress and posttraumatic growth in caregivers of pediatric burn patients undergoing mHealth-enhanced outpatient burn care: A pilot study.

Approximately 120,000 children in the United States are evaluated in the emergency department annually due to burn injuries. Studies have consistently documented that pediatric burns are among the most stressful events for caregivers, resulting in a wide range of emotions, including guilt, anxiety, grief, depression, and posttraumatic stress symptoms, as well as positive psychological changes, a phenomenon known as posttraumatic growth. The present pilot study aimed to explore the prevalence of elevated perceived stress as well as posttraumatic growth among caregivers of pediatric burn patients receiving outpatient burn care and using an mHealth burn platform to administer burn treatment. Our results demonstrated that, on average, caregivers endorsed similar or lower levels of perceived stress over the past 30 days compared to the general population of 30-44-year-old adults and only a third of caregivers reported elevated levels of perceived stress in the past 30 days. However, during the treatment phase, two-thirds of caregivers reported elevated levels of stress. Further, approximately half of the caregiver sample reported moderate to high levels of posttraumatic growth following their child's burn injury. This pilot study clarifies the level of the perceived stress that caregivers of burn-injured children experience, particularly during the treatment phase when they are responsible for their children's outpatient burn care (e.g., dressing changes). Additionally, the results shed light on the high prevalence of moderate to high posttraumatic growth in caregivers, with a prevalence rate similar to other trauma survivors.

Motives matter: The psychological experience of ostracizing among sources.

Individuals ostracize others for myriad reasons, yet the influence of those reasons on the psychological experience of ostracizing is yet unknown. Two studies aimed to determine the emotional and behavioral sequelae of ostracizing for different motives, directly comparing punitive to defensive motives. We focused our examination on a suite of emotions expected to arise as a function of (1) the situations that give rise to ostracizing for punitive and defensive reasons (anger, fear, anxiety, and sadness) and (2) the act of ostracizing itself (i.e., pride and guilt). The research employed a novel paradigm to induce the experience of ostracizing for defensive or punitive motives. Study 1 (N = 372) investigated sources' experienced emotion as a function of motive. Study 2 (N = 743) expanded consideration to behavioral intentions, including intentions to continue ostracizing and to recruit others to join in ostracizing the target. Across both studies and supported by an internal meta-analysis, ostracizing for defensive reasons was associated with higher levels of guilt, fear, and anxiety, and lower levels of anger, compared to ostracizing for punitive reasons. Neither sadness nor positive emotion (pride or happiness) differed significantly according to motive in either study. Moreover, guilt and anger mediated the impact of motive on intentions to continue ostracizing and recruit others to join them in ostracizing. To the extent that punitive sources experienced anger relative to defensive sources, they expressed greater intentions to continue ostracizing the target and to recruit others to join in ostracizing the target. To the extent that defensive sources experienced guilt relative to punitive sources, they reported reduced intentions to continue ostracizing the target. Findings add to a growing literature on ostracism sources, and highlight the mediating role of sources' emotion in guiding future actions.

Virtual reality-assessment of social interactions and prognosis in depression.

BACKGROUND: Freud proposed that excessive self-blame-related motivations such as self-punishing tendencies play a key role in depression. Most of the supporting evidence, however, is based on cross-sectional studies and questionnaire measures. METHODS: In this pre-registered (NCT04593537) study, we used a novel Virtual Reality (VR) task to determine whether maladaptive self-blame-related action tendencies prospectively identify a subgroup of depression with poor prognosis when treated as usual over four months in primary care. Ninety-eight patients with depression (Patient Health Questionnaire-9 ≥ 15), screening negatively for bipolar and alcohol/substance use disorders, completed the VR-task at baseline (n = 93 completed follow-up). RESULTS: Our pre-registered statistical/machine learning model prospectively predicted a cross-validated 19 % of variance in depressive symptoms. Contrary to our specific predictions, and in accordance with Freud's observations, feeling like punishing oneself emerged as prognostically relevant rather than feeling like hiding or creating a distance from oneself. Using a principal components analysis of all pre-registered continuous measures, a factor most strongly loading on feeling like punishing oneself for other people's wrongdoings (ß = 0.23, p = 0.01), a baseline symptom factor (ß = 0.30, p = 0.006) and Maudsley Staging Method treatment-resistance scores (ß = 0.28, p = 0.009) at baseline predicted higher depressive symptoms after four months. LIMITATIONS: Patients were not assessed with a diagnostic interview. CONCLUSIONS: Independently and apart from known clinical variables, feeling like punishing oneself emerged as a distinctly relevant prognostic factor and should therefore be assessed and tackled in personalised care pathways for difficult-to-treat depression.

A latent profile analysis of moral emotions following moral transgressions.

OBJECTIVE: Moral transgressions (MTs), events that violate one's moral code, are associated with the moral emotions of guilt and shame. However, there may be different patterns by which people experience guilt and shame that affect distress following MTs. METHOD: Undergraduates (N = 1371) exposed to an MT completed self-report assessments. This study used latent profile analysis (LPA) to examine profiles based on guilt cognitions, internalized shame, and distress in relation to a reported MT. Cognitive flexibility, years since the MT, and deliberate and intrusive rumination were examined as variables to determine how these factors predicted profile membership. RESULTS: Results from the LPA revealed a three-profile solution: a low moral distress profile (n = 1002), a moderate moral distress profile (n = 262), and a shame prominent profile (n = 107). Results indicated that higher levels of deliberate and intrusive rumination and lower levels of cognitive flexibility significantly increased the likelihood of belonging to the moderate moral distress or shame prominent profiles compared to the low moral distress profile. Higher levels of intrusive rumination and lower levels of cognitive flexibility also significantly increased the likelihood of belonging to the shame prominent profile over the moderate distress profile. CONCLUSION: Three different profiles emerged, with the shame prominent profile being driven primarily by internalized shame. Results suggest that intrusive rumination and cognitive inflexibility are risk factors to experiencing adverse responses to MTs.

Internalized Sexual Stigma and Mental Health Outcomes for Gay, Lesbian, and Bisexual Asian Americans: The Moderating Role of Guilt and Shame.

The literature unequivocally demonstrates that lesbian, gay, and bisexual (LGB) individuals experience disproportionate mental health and social wellbeing impacts. Here, we respond to recent calls for research in the field of sexual minority health to better understand why various overlapping and intersecting identities can further drive health disparities. In this paper, we focus on the specific intersections of ethnicity and sexuality for Asian LGB individuals and the role of internalized stigma in driving poorer mental health outcomes for this group. We recruited 148 LGB Asian participants residing in the United States (Mage = 22.82 years, SD = 4.88) to participate in our online cross-sectional survey in which we collected data on their internalized stigma, levels of guilt and shame about their sexuality, and measures of depression, anxiety, and distress. Contrary to our predictions, there were no bivariate relationships between internalized sexual stigma and any of the mental health outcomes. However, a parallel mediation analysis revealed that guilt, but not shame, mediates the relationship between internalized sexual stigma and all mental health outcomes (depression, anxiety, and stress) for LGB Asian American individuals. This research highlights the important of exploring additional variables that may exacerbate of protect against poor mental health for individuals with multiple intersecting identities.

Longitudinal effects of ambivalent and guilt feelings on dementia family caregivers' depressive symptoms.

BACKGROUND: The world prevalence of people with dementia is increasing. Most of the care received by people with dementia is provided by family caregivers, and this prolonged activity has a significant impact on caregivers' levels of depression. Stressors and frequency of leisure are known predictors of caregivers' depressive levels. The longitudinal impact of caregivers' ambivalent and guilt feelings is unknown. METHODS: Participants were 177 family caregivers of relatives with dementia who were assessed three times during a 2-year period. In addition to demographic variables, psychological symptoms of the dementias, and frequency of leisure activities, caregivers' ambivalent feelings, guilt, and depressive symptoms were measured. The longitudinal association of changes in these variables with changes in caregivers' depressive symptoms over time was assessed using mixed linear models. RESULTS: Changes over time in the assessed variables predicted 48.05% of variance of changes over time in depressive symptoms. Even when variables strongly associated with increased depressive symptoms were controlled (lower caregivers' age and educational level, higher reaction to BPSD, and lower leisure activities), increases in ambivalence and guilt contributed to an increase of 9.22% of the variance of changes depressive symptoms over a 2-year period. The effects of ambivalent feelings on depression are indirect, mediated by guilt feelings. Cessation of caregiving do not seem to alter these findings. CONCLUSIONS: Caregivers' ambivalent and guilt feelings are significant predictors of caregivers' mental health. Caregivers may significantly benefit from early detection of ambivalent and guilt feelings and preventive strategies targeting triggers associated with ambivalent and guilt symptoms.

Non-fear emotions in changes in posttraumatic stress disorder symptoms during treatment.

BACKGROUND AND OBJECTIVES: Posttraumatic stress disorder (PTSD) is not only associated with fear but also with other emotions. The present study aimed to examine if changes in shame, guilt, anger, and disgust predicted changes in PTSD symptoms during treatment, while also testing if PTSD symptoms, in turn, predicted changes in these emotions. METHODS: Participants (N = 155) with childhood-related PTSD received a maximum of 12 sessions of eye movement desensitization and reprocessing or imagery rescripting. The data was analyzed using Granger causality models across 12 treatment sessions and 6 assessment sessions (up until one year after the start of treatment). Differences between the two treatments were explored. RESULTS: Across treatment sessions, shame, and disgust showed a reciprocal relationship with PTSD symptoms, while changes in guilt preceded PTSD symptoms. Across assessments, anger was reciprocally related to PTSD, suggesting that anger might play a more important role in the longer term. LIMITATIONS: The individual emotion items were not yet validated, and the CAPS was not administered at all assessments. CONCLUSIONS: These findings partly differ from earlier studies that suggested a unidirectional relationship in which changes in emotions preceded changes in PTSD symptoms during treatment. This is in line with the idea that non-fear emotions do play an important role in the treatment of PTSD and constitute an important focus of treatment and further research.

The influence of trauma symptoms on interpersonal attributions in daily life.

There is well-documented evidence that trauma exposure can disrupt relationships. However, limited research has examined whether posttraumatic stress symptoms (PTSS) moderate interpersonal processes in daily life. To this end, undergraduates (N = 98) completed a measure of PTSS at baseline. They then completed smartphone-based surveys after every interpersonal interaction that lasted longer than 3 min. for 10 days. These surveys assessed perceptions of self and other agency and communion as well as feelings of rejection, neglect, abandonment, worthlessness, emptiness, guilt, and shame. Results of multilevel modeling suggest that interpersonal perception and PTSS predicted 10%-26% of the variance in outcomes. Regarding agency, more agentic participants reported higher levels of negative attributions, γs = .47-.56. Participants also reported higher rejection and guilt when they experienced their interaction partner as more agentic than usual, γs = .07, and PTSS did not moderate these associations. For communal perceptions, participants who experienced themselves and others as warmer than other participants reported fewer negative outcomes, γs = -.44--.58. Individuals also reported more negative outcomes when they experienced themselves and others as warmer than they usually did, γs = -.10--.28, and PTSS moderated these associations. The negative associations between self- and other communion ratings and feelings of neglect, abandonment, and shame were stronger in individuals with higher PTSS scores. Together, these findings support continued efforts to understand the ways in which trauma exposure and PTSS disrupt interpersonal dynamics in daily life.

Chapitre 1. Manger à l'ère de la transition alimentaire : entre libertés et sujétions.

In light of the increasing number and complexity of food products on offer to meet the challenges of the food transition, this article looks at the consequences for consumers’ freedom of choice. This freedom of choice cannot be based on total autonomy, which generally leads to a loss of dietary reference points and guilt, or on radical heteronomy dictated by science or hygienic-ecological rationalities, which create tensions and divisions in society. Rather, dietary freedom is an effort to free oneself from the burden of a criterion-based vision of food. It calls for the restoration of an ethic of eating together, based on values and rules capable of preserving common goods and the well-being and survival of our fellow human beings.

Differences in the link between social trait judgment and socio-emotional experience in neurotypical and autistic individuals.

Neurotypical (NT) individuals and individuals with autism spectrum disorder (ASD) make different judgments of social traits from others' faces; they also exhibit different social emotional responses in social interactions. A common hypothesis is that the differences in face perception in ASD compared with NT is related to distinct social behaviors. To test this hypothesis, we combined a face trait judgment task with a novel interpersonal transgression task that induces measures social emotions and behaviors. ASD and neurotypical participants viewed a large set of naturalistic facial stimuli while judging them on a comprehensive set of social traits (e.g., warm, charismatic, critical). They also completed an interpersonal transgression task where their responsibility in causing an unpleasant outcome to a social partner was manipulated. The purpose of the latter task was to measure participants' emotional (e.g., guilt) and behavioral (e.g., compensation) responses to interpersonal transgression. We found that, compared with neurotypical participants, ASD participants' self-reported guilt and compensation tendency was less sensitive to our responsibility manipulation. Importantly, ASD participants and neurotypical participants showed distinct associations between self-reported guilt and judgments of criticalness from others' faces. These findings reveal a novel link between perception of social traits and social emotional responses in ASD.