Survivor’s guilt is when a person has feelings of guilt because they survived a life-threatening situation when others did not. It is a common reaction to traumatic events and a symptom of post-traumatic stress disorder (PTSD).
In this article, we explore the phenomenon of survivor’s guilt and look at its symptoms and causes. We also discuss some tips for overcoming survivor’s guilt and explain when to seek professional help.
What is survivor’s guilt?
Survivor’s guilt can occur in relation to a traumatic event or a loss of life. When a person survives an event that others did not, it can lead to feelings of guilt.
Psychologists from the Medical University of South Carolina have just published one of the largest post-disaster screening projects in U.S. history. The report, available online through JAMA Network Open, measured the magnitude of Hurricane Maria’s impact on the mental health of children in Puerto Rico.
Rosaura Orengo-Aguayo, an assistant professor at MUSC in the Department of Psychiatry and Behavioral Sciences, grew up in Puerto Rico and led the study. “More than seven percent of youth, 6,900 of the children surveyed by the Puerto Rico Department of Education, reported clinically significant symptoms of PTSD,” she said.
Post-traumatic stress disorder can develop after a traumatic event, such as a natural disaster, affecting their ability to cope with everyday life. PTSD can cause nightmares, flashbacks, the feeling of being always on guard, trouble sleeping and an inability to remember parts of the traumatic event.
Post-traumatic stress disorder (PTSD) and alcohol dependence (AD) are two of the most common and debilitating disorders diagnosed among American military veterans. AD and PTSD often occur together, and this co-occurrence has a worse prognosis than either disorder alone. Alcohol craving is related to relapse, but the relationship between PTSD symptoms, craving, and relapse is not well understood. This study is the first to explore the effects of trauma-induced and stress-induced imagery on alcohol craving, affect, and cardiovascular and cortisol responses in a laboratory setting.
Researchers examined 25 veterans who had been diagnosed with AD and PTSD and were participating in a randomized treatment trial. At baseline, participants’ PTSD symptoms and drinking quantity and frequency during the three-month pretreatment period were assessed. During the session, the participants were exposed to neutral, stressful, and traumatic imagery in random order. The main outcomes included craving, anxiety, mood states, salivary cortisol, and cardiovascular responses.
Many people get on with their lives after traumatic experiences without any psychological suffering. This is because, in spite of all the trauma, they manage to pigeonhole what they have experienced. Although this sense of coherence was first described in the 1970s, measuring it has remained problematic to this day. Psychologists from the University of Zurich have now developed a questionnaire that renders the sense of coherence in overcoming trauma tangible in a more appropriate way.
In the 1970s, Israeli medical psychologist Aron Antonovsky provided evidence of a mental — or cognitive — ability: Although many Holocaust survivors still suffered mentally and physically from their ordeal decades later, others remained healthy or recovered. Certain people evidently succeed in pigeonholing and processing traumatic experiences mentally, even if they still have such a horrific impact on their own lives. Antonovsky singled out this sense of coherence as a central trait for what is usually referred to as “resilience” — psychological resistance. A questionnaire that he developed has been used to study the sense of coherence internationally in many research programs ever since. However, the questionnaire exhibits conceptual and methodological errors, which basic psychological research has been aware of for quite some time.
An average of 30 years had passed since the traumatic events that had left them depressed, anxious, irritable, hypervigilant, unable to sleep well and prone to nightmares.
But for 12 people who were involved in a UCLA-led study — survivors of rape, car accidents, domestic abuse and other traumas — an unobtrusive patch on the forehead provided considerable relief from post-traumatic stress disorder.
“We’re talking about patients for whom illness had almost become a way of life,” said Dr. Andrew Leuchter, the study’s senior author, a UCLA professor of psychiatry and director of the neuromodulation division at UCLA’s Semel Institute for Neuroscience and Human Behavior. “Yet they were coming in and saying, ‘For the first time in years I slept through the night,’ or ‘My nightmares are gone.’ The effect was extraordinarily powerful.”
A new study of young U.S. veterans shows that the probability of having a high risk of obstructive sleep apnea (OSA) increased with increasing severity of post-traumatic stress disorder (PTSD) symptoms.
The study involved 195 Iraq and Afghanistan veterans who visited a VA outpatient PTSD clinic for evaluation. Results show that 69.2 percent of participants had a high risk for sleep apnea, and this risk increased with PTSD symptom severity. Every clinically significant increase in PTSD symptom severity was associated with a 40 percent increase in the probability of screening as high risk for sleep apnea.
“The implication is that veterans who come to PTSD treatment, even younger veterans, should be screened for obstructive sleep apnea so that they have the opportunity to be diagnosed and treated,” said co-principal investigator Sonya Norman, PhD, researcher at the San Diego VA, director of the PTSD Consultation Program at the National Center for PTSD, and an associate professor of psychiatry at the University of California San Diego School of Medicine. “This is critical information because sleep apnea is a risk factor for a long list of health problems such as hypertension, cardiovascular disease and diabetes, and psychological problems including depression, worsening PTSD and anxiety.”
Evaluating military personnel with blast-related mild traumatic brain injuries, researchers have found that early symptoms of post-traumatic stress, such as anxiety, emotional numbness, flashbacks and irritability, are the strongest predictors of later disability.
The results were surprising because mental health more closely correlated with disability than assessments typically made after concussions, such as tests of memory, thinking, balance, coordination and severity of headaches and dizziness, according to the study led by Washington University School of Medicine in St. Louis.
“Symptoms of post-traumatic stress and depression have always been thought to develop months to years later,” said David L. Brody, MD, PhD, associate professor of neurology at Washington University. “We don’t know what causes these symptoms, whether they result from the brain injury itself, from the stress of war or some combination of factors. But regardless of their origin, the severity of these psychological symptoms soon after injury was the strongest predictor of later disability.”
Young women with ADHD who have been exposed to abuse, neglect or other traumas in childhood and adolescence are at greater risk for self-injury, eating disorders and suicide than those with ADHD who were not mistreated in early youth, according to new research from UC Berkeley.
The findings, just reported in the journal Development and Psychopathology, add to a growing body of evidence that environmental factors, including maltreatment in childhood, can have a significant bearing on the negative psychosocial outcomes of attention-deficit hyperactivity disorder.
“While ADHD is clearly a heritable and biologically based disorder, and can be treated with medications, it is very important for clinicians and treatment providers to pay close attention to the trauma experiences of individuals, particularly women, with ADHD,” said Maya Guendelman, a Ph.D. student in psychology at UC Berkeley, and lead author of the study.
The majority (55-74%) of adolescents entering substance use treatment also have psychiatric disorders, such as depression, ADHD and trauma-related problems. Unfortunately, these youth face poorer treatment outcomes (e.g., relapse), and their mental health issues are often not directly addressed. Furthermore, few studies exist to guide those clinicians who would like to use integrated care to treat adolescent with co-occurring disorders.
A review published in the new Substance Abuse Special Issue: Evaluating and Addressing Adolescent Alcohol and Other Substance Use Disorders proposes that the Adolescent Community Reinforcement Approach (A-CRA), which is a combination of cognitive-behavioral and family therapies, may be an ideal treatment method for this patient population.
Traumatic events leave their mark. People exposed to a traumatic experience early in life are more likely to be affected by illnesses such as borderline personality disorder or depression. However such experience can also have positive effects in certain circumstances. Thus, moderate stress in childhood may help a person develop strategies to better cope with stress in adulthood.
Further, it has long been recognised by psychologists and psychiatrists that the negative effects of trauma experienced by parents can be seen in their children, but the molecular mechanisms underlying such transmission are only beginning to be identified. A research team led by Isabelle Mansuy, Professor of Neuroepigenetics at the University of Zurich and ETH Zurich, has for the first time tested in mice the degree to which the beneficial effects of stress can be passed to following generations.