Shame as a mediator between posttraumatic stress disorder symptoms and suicidal ideation among veterans

Abstract Background Suicidal ideation is a problem that disproportionately affects veterans. Moreover, veterans with posttraumatic stress disorder (PTSD) appear to be at particularly high risk for suicide. Objective The purpose of the present research was to examine whether shame mediates the association between PTSD and suicidal ideation. Methods Secondary analyses were conducted in a sample of 201 veterans with PTSD seeking care through an outpatient Veterans Affairs specialty PTSD clinic. Results Path analysis revealed that shame fully accounted for the effects of PTSD on suicidal ideation, suggesting that shame may represent a key link between PTSD and suicidal ideation among veterans. Limitations Although the reverse mediation effect was also examined, the present sample was cross-sectional and predominantly male. Conclusions The present findings suggest that shame may be an effective point of treatment intervention to reduce suicidal ideation among veterans with PTSD; however, additional prospective research is still needed to delineate the precise nature of these associations over time.