Project Title

SELF-COMPASSION AND SUICIDE RISK IN VETERANS: SERIAL EFFECTS OF SHAME, GUILT, AND PTSD

Authors' Affiliations

Peter C. Britton, Ph.D., Center of Excellence in Suicide Prevention, Canandaigua Veterans Administration Medical Center Jameson K. Hirsch, Ph.D., Department of Psychology, East Tennessee State University

Location

AUDITORIUM ROOM 137B

Start Date

4-4-2018 9:00 AM

End Date

4-4-2018 9:15 AM

Name of Project's Faculty Sponsor

Jameson K. Hirsch, Ph.D.

Faculty Sponsor's Department

Psychology

Type

Oral Presentation

Classification of First Author

Graduate Student-Doctoral

Project's Category

Social and Behavioral Sciences

Abstract Text

Suicide is a significant public health concern in the U.S., with over 40,000 suicides reported in 2014. For veterans, risk for suicide is even greater; for instance, of the over 40,000 suicides in 2014, 18% were comprised of veterans, although veterans account for only 8% of the U.S. population. Heightened suicide risk in veterans may be due to increased exposure to trauma (e.g., military sexual trauma, combat) and its negative cognitive-emotional sequelae (i.e., shame, guilt, PTSD). However, not all veterans who experience these negative symptoms manifest suicide risk, potentially due to the presence of protective factors. One such factor, self-compassion, involves responding to oneself in a caring and helpful manner in times of distress and may buffer against suicide risk by allowing the individual to look past global negative self-evaluations (i.e., shame), breaking the ruminative cycle over past actions (i.e., guilt), and helping to alleviate PTSD symptoms. This premise, however, has not been tested. We hypothesized that shame/guilt and PTSD symptoms (in two separate models) would mediate the relation between self-compassion and suicide risk, such that higher levels of self-compassion will be associated with lower levels of shame/guilt and, in turn, to decreased PTSD symptoms and reduced suicide risk.

Participants (N=317; 65.6% male (n=208); 83.6% Caucasian (n=265), Mean Age=47.54, SD=16.34) were community-dwelling veterans who self-identified as having experienced a trauma, and completed the Self-Compassion Scale-Short Form, Differential Emotions Scale-IV, PTSD Checklist-Military Version, and the Suicide Behaviors Questionnaire-Revised. Bivariate correlations and serial mediation analyses were conducted covarying age, sex, ethnicity, VHA usage, service era, and depressive symptoms. Supporting hypotheses, in serial mediation analyses (10000 bootstrapped samples), the direct effect of self-compassion on suicide risk was reduced, but remained significant, when shame and PTSD symptoms (Model 1; c'=-.846, p=.002, CI=-1.39 to -.306) and guilt and PTSD symptoms (Model 2; c'=-.588, p=.043, CI=-1.15 to -.020), were added as mediators, indicating mediation. Further, there were significant total and specific indirect effects in both models.

Our results suggest that the relation between self-compassion and suicide risk may be due, in part, to beneficial changes in cognitive-emotional factors and subsequent decreased severity of PTSD symptoms. Engaging in self-kindness and mindfulness may provide a more-balanced, rather than judgmental and overly-responsible, view of one’s self, thereby reducing risk for psychopathology and suicide. Our findings may have clinical implications. Encouraging the development of self-compassion (e.g., Mindful Self-Compassion, Compassion-Focused Therapy) and addressing shame, guilt, and PTSD symptoms (e.g., Cognitive Processing Therapy, Adaptive Disclosure), may reduce suicide risk in the veteran population.

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Apr 4th, 9:00 AM Apr 4th, 9:15 AM

SELF-COMPASSION AND SUICIDE RISK IN VETERANS: SERIAL EFFECTS OF SHAME, GUILT, AND PTSD

AUDITORIUM ROOM 137B

Suicide is a significant public health concern in the U.S., with over 40,000 suicides reported in 2014. For veterans, risk for suicide is even greater; for instance, of the over 40,000 suicides in 2014, 18% were comprised of veterans, although veterans account for only 8% of the U.S. population. Heightened suicide risk in veterans may be due to increased exposure to trauma (e.g., military sexual trauma, combat) and its negative cognitive-emotional sequelae (i.e., shame, guilt, PTSD). However, not all veterans who experience these negative symptoms manifest suicide risk, potentially due to the presence of protective factors. One such factor, self-compassion, involves responding to oneself in a caring and helpful manner in times of distress and may buffer against suicide risk by allowing the individual to look past global negative self-evaluations (i.e., shame), breaking the ruminative cycle over past actions (i.e., guilt), and helping to alleviate PTSD symptoms. This premise, however, has not been tested. We hypothesized that shame/guilt and PTSD symptoms (in two separate models) would mediate the relation between self-compassion and suicide risk, such that higher levels of self-compassion will be associated with lower levels of shame/guilt and, in turn, to decreased PTSD symptoms and reduced suicide risk.

Participants (N=317; 65.6% male (n=208); 83.6% Caucasian (n=265), Mean Age=47.54, SD=16.34) were community-dwelling veterans who self-identified as having experienced a trauma, and completed the Self-Compassion Scale-Short Form, Differential Emotions Scale-IV, PTSD Checklist-Military Version, and the Suicide Behaviors Questionnaire-Revised. Bivariate correlations and serial mediation analyses were conducted covarying age, sex, ethnicity, VHA usage, service era, and depressive symptoms. Supporting hypotheses, in serial mediation analyses (10000 bootstrapped samples), the direct effect of self-compassion on suicide risk was reduced, but remained significant, when shame and PTSD symptoms (Model 1; c'=-.846, p=.002, CI=-1.39 to -.306) and guilt and PTSD symptoms (Model 2; c'=-.588, p=.043, CI=-1.15 to -.020), were added as mediators, indicating mediation. Further, there were significant total and specific indirect effects in both models.

Our results suggest that the relation between self-compassion and suicide risk may be due, in part, to beneficial changes in cognitive-emotional factors and subsequent decreased severity of PTSD symptoms. Engaging in self-kindness and mindfulness may provide a more-balanced, rather than judgmental and overly-responsible, view of one’s self, thereby reducing risk for psychopathology and suicide. Our findings may have clinical implications. Encouraging the development of self-compassion (e.g., Mindful Self-Compassion, Compassion-Focused Therapy) and addressing shame, guilt, and PTSD symptoms (e.g., Cognitive Processing Therapy, Adaptive Disclosure), may reduce suicide risk in the veteran population.