NRSA Fellowship for Tipsword: The Experience and Regulation of Posttraumatic Shame among Women with Histories of Interpersonal Trauma

Project Summary/Abstract. Approximately 14 million women in the United States will develop posttraumatic stress disorder (PTSD) during their lifetime following interpersonal trauma (IPT; physical or sexual assault/abuse). Posttraumatic shame – an emotion stemming from harsh attitudes about the self after trauma – is central to PTSD for many IPT-exposed women. Yet, knowledge of the frequency, intensity, duration, and triggers of shame in the daily lives of women with IPT histories is lacking. Further, though shame and guilt (an emotion defined by negative feelings about one’s actions) are studied separately by researchers, no work has assessed whether women with IPT histories make similar distinctions and see shame and guilt as differentially influencing their recovery from IPT. While some work has begun to explore shame-specific emotion regulation (ER), or processes aimed at changing emotional responses to meet specific goals, it remains unclear which – if any – ER strategies are effective in reducing the frequency, intensity, or duration of shame. Other factors likely to shape posttraumatic shame regulation – including perceived effectiveness of ER strategies, goals of ER, and PTSD severity – also have yet to be explored. Addressing these gaps could strengthen treatments for shame and PTSD. This project will use a sequential mixed methods design to explore 1) daily experiences of posttraumatic shame (including triggers; frequency/intensity/duration; relations to PTSD symptoms; changes over time; and factors distinguishing shame from guilt) and 2) regulation of posttraumatic shame (including use and perceived effectiveness of ER strategies and roles of PTSD symptoms and ER goals in shame regulation). Aims will be assessed quantitatively (Study 1) and qualitatively (Study 2). Study 1 will involve secondary analysis of experience sampling data on shame and ER obtained 5 times per day for 13 days from 60 women with IPT histories and varying levels of PTSD symptoms. Study 2 will involve qualitative interviews with 20-40 IPT-exposed women on the experience and regulation of posttraumatic shame. It is expected that higher shame will predict higher subsequent PTSD symptoms (and vice versa); more frequent rumination, emotion suppression, and distraction; and less frequent emotion sharing, emotional reflection, and reappraisal within persons and across days. Relations between shame and ER strategies are expected to be stronger among women with more severe PTSD symptoms, and reverse models (ER predicting shame) will be tested. Novel findings on triggers, distinctions between shame and guilt, and shame frequency/intensity/duration/variability are expected, along with insights into roles of perceived effectiveness, PTSD symptoms, and ER goals in shame regulation. Greater understanding of the experience and regulation of posttraumatic shame could improve treatments for shame and PTSD among IPT-exposed women and will be key to advancing the PI’s research. This training grant will facilitate the PI’s progression toward an independent, grant-funded research career examining the role of emotional vulnerabilities in PTSD among women with IPT histories.