{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T17:56:11Z","timestamp":1774634171530,"version":"3.50.1"},"reference-count":37,"publisher":"Royal College of Psychiatrists","issue":"1","license":[{"start":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T00:00:00Z","timestamp":1704931200000},"content-version":"unspecified","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec id=\"S2056472423006245_sec_a1\">\n\t    <jats:title>Background<\/jats:title>\n\t    <jats:p>Trauma-related shame and guilt have been identified as important factors for mental health following interpersonal trauma. For survivors of terror and disasters, however, the role of shame and guilt remains largely unknown.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472423006245_sec_a2\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>To explore the long-term occurrence of trauma-related shame and guilt among survivors of a terror attack, and the potential importance of these emotions for mental health.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472423006245_sec_a3\" sec-type=\"methods\">\n\t    <jats:title>Method<\/jats:title>\n\t    <jats:p>A total of 347 survivors (48.7% female, mean age at the time of the attack: 19.25 years, s.d. = 4.40) of the 2011 massacre on Ut\u00f8ya island, Norway, participated in face-to-face, semi-structured interviews. Trauma-related shame and guilt were measured with items from the Shame and Guilt After Trauma Scale at 2.5 and 8.5 years post-terror attack. Post-traumatic reactions and anxiety\/depression at 8.5 years post-terror attack were measured with the University of California at Los Angeles PTSD Reaction Index and the Hopkins Symptom Checklist-25, respectively. Associations between trauma-related shame\/guilt and post-trauma psychopathology were analysed by multiple linear regressions.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472423006245_sec_a4\" sec-type=\"results\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>Trauma-related shame and guilt were prevalent among survivors at both 2.5 and 8.5 years post-terror attack. In unadjusted analyses, shame and guilt, at both time points, were significantly associated with post-traumatic stress reactions and anxiety\/depression. Shame remained significantly associated with mental health when adjusted for guilt. Both earlier and current shame were uniquely related to mental health.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472423006245_sec_a5\" sec-type=\"conclusions\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>Trauma-related shame and guilt may be prevalent in survivors of mass trauma several years after the event. Shame, in particular, may play an important role for long-term mental health. Clinicians may find it helpful to explicitly address shame in treatment of mass trauma survivors.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1192\/bjo.2023.624","type":"journal-article","created":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T09:16:58Z","timestamp":1704964618000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":3,"title":["What will others think of me? The longitudinal association between trauma-related shame and guilt and psychopathology after a terror attack"],"prefix":"10.1192","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9965-8595","authenticated-orcid":false,"given":"Kristin Alve","family":"Glad","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helene Flood","family":"Aakvaag","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tore","family":"Wentzel-Larsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grete","family":"Dyb","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5688-7948","authenticated-orcid":false,"given":"Siri","family":"Thoresen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"170","published-online":{"date-parts":[[2024,1,11]]},"reference":[{"key":"S2056472423006245_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2021.102443"},{"key":"S2056472423006245_ref14","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22411"},{"key":"S2056472423006245_ref27","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-004-0048-2"},{"key":"S2056472423006245_ref34","doi-asserted-by":"publisher","DOI":"10.1037\/a0021466"},{"key":"S2056472423006245_ref5","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291722001866"},{"key":"S2056472423006245_ref21","doi-asserted-by":"publisher","DOI":"10.3390\/jcm5110094"},{"key":"S2056472423006245_ref9","first-page":"742","volume-title":"Handbook of Emotions","author":"Lewis","year":"2008"},{"key":"S2056472423006245_ref16","doi-asserted-by":"publisher","DOI":"10.1002\/jts.21957"},{"key":"S2056472423006245_ref15","doi-asserted-by":"publisher","DOI":"10.1348\/000711201161109"},{"key":"S2056472423006245_ref17","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-032013-182435"},{"key":"S2056472423006245_ref25","article-title":"Post-traumatic stress reactions in survivors of the 2011 massacre on Ut\u00f8ya Island, Norway","volume":"204","author":"Dyb","year":"2014","journal-title":"BJPsych"},{"key":"S2056472423006245_ref37","doi-asserted-by":"publisher","DOI":"10.1002\/jts.21971"},{"key":"S2056472423006245_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(96)00034-4"},{"key":"S2056472423006245_ref2","doi-asserted-by":"publisher","DOI":"10.1891\/0886-6708.16.1.65"},{"key":"S2056472423006245_ref36","doi-asserted-by":"publisher","DOI":"10.3402\/ejpt.v7.29715"},{"key":"S2056472423006245_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2016.06.004"},{"key":"S2056472423006245_ref8","unstructured":"8 Aakvaag, HF . Violence, revictimization and trauma-related shame and guilt. An investigation of event characteristics and mental health correlates among violence exposed men and women from the general population and among young survivors of a terrorist attack . PhD doctoral thesis Faculty of Psychology, University of Oslo, 2016."},{"key":"S2056472423006245_ref35","doi-asserted-by":"publisher","DOI":"10.1002\/jts.20108"},{"key":"S2056472423006245_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/S1077-7229(05)80004-5"},{"key":"S2056472423006245_ref33","doi-asserted-by":"publisher","DOI":"10.1080\/20008198.2019.1620084"},{"key":"S2056472423006245_ref26","volume-title":"UCLA PTSD Index for DSM-IV","author":"Pynoos","year":"1998"},{"key":"S2056472423006245_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2016.11.026"},{"key":"S2056472423006245_ref3","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-23645-8_18"},{"key":"S2056472423006245_ref18","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.106.030262"},{"key":"S2056472423006245_ref7","doi-asserted-by":"publisher","DOI":"10.1002\/1099-0879(200007)7:3<174::AID-CPP236>3.0.CO;2-U"},{"key":"S2056472423006245_ref24","volume-title":"Learning for Better Emergency Preparedness: The Medical Response to the Terrorist Incidents of 22 July 211 (IS-1984)","year":"2012"},{"key":"S2056472423006245_ref31","doi-asserted-by":"publisher","DOI":"10.1016\/j.jrp.2005.11.007"},{"key":"S2056472423006245_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2015.04.026"},{"key":"S2056472423006245_ref30","doi-asserted-by":"publisher","DOI":"10.1111\/j.2044-8341.1997.tb01893.x"},{"key":"S2056472423006245_ref29","doi-asserted-by":"publisher","DOI":"10.1080\/08039480310000932"},{"key":"S2056472423006245_ref28","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsq054"},{"key":"S2056472423006245_ref19","doi-asserted-by":"publisher","DOI":"10.1080\/09546553.2023.2214238"},{"key":"S2056472423006245_ref1","doi-asserted-by":"publisher","DOI":"10.1037\/1040-3590.8.4.428"},{"key":"S2056472423006245_ref12","volume-title":"Shame and Guilt","author":"Tangney","year":"2003"},{"key":"S2056472423006245_ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2018.06.002"},{"key":"S2056472423006245_ref13","doi-asserted-by":"publisher","DOI":"10.1037\/0021-843X.101.3.469"},{"key":"S2056472423006245_ref23","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.181.5.433"}],"container-title":["BJPsych Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2056472423006245","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T09:17:04Z","timestamp":1704964624000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2056472423006245\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":37,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1]]}},"alternative-id":["S2056472423006245"],"URL":"https:\/\/doi.org\/10.1192\/bjo.2023.624","relation":{},"ISSN":["2056-4724"],"issn-type":[{"value":"2056-4724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2024. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e30"}}