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Focusing mainly on the effects of fear and helplessness in PTSD, shame has been described as being anunderestimated possible factor for post trauma reactions. Shame and shame proneness have independently been shown to predict maladjustment after traumatizing events like criminal victimization, while guilt typically is described as unrelated to symptomatology. In a cross-sectional study, victims of interpersonal violence were investigated. Measures of shame and guilt proneness as well as self-rated experienced shame and guilt in association with the crime were related to symptomatology (PTSD-specific as well as general psychiatric symptoms). The shame measures were independently related to symptomatology but also to each other, while the guilt measures were unrelated to symptomatology and to each other. Further, event-related shame appeared as mediator between shame-proneness and post-victimization symptoms. A better understanding of the relationship between event-related emotions like shame and guilt and the propensity to react with shame or guiltmay have important clinical implications. Some suggestions as to how we move on from here will bepresented.

To increase understanding of post-victimization symptom development, the present study investigated the role of shame- and guilt-proneness and event-related shame and guilt as potential risk factors. 35 individuals (M age = 31.7 yr.; 48.5% women), recently victimized by a single event of severe violent crime, were assessed regarding shame- and guilt-proneness, event-related shame and guilt, and post-victimization symptoms. The mediating role of event-related shame was investigated with structural equation modeling (SEM), using bootstrapping. The guilt measures were unrelated to each other and to post-victimization symptoms. The shame measures were highly intercorrelated and were both positively correlated to more severe post-victimization symptom levels. Event-related shame as mediator between shame-proneness and post-victimization symptoms was demonstrated by prevalent significant indirect effects. Both shame measures are potent risk factors for distress after victimization, whereby part of the effect of shame-proneness on post-victimization symptoms is explained by event-related shame.

This study investigated the relationships between shame- and guilt-proneness, event-related shame and guilt, andpost-victimization symptoms among 35 victims (17 females and 18 males; mean age 31.7 years) of a single severe violent crime. Shame- and guilt-proneness (Test of Self-Conscious Affect) and event-related shame and guilt (Visual Analog Scale) were related to post-victimization symptoms (Harvard Trauma Questionnaire and SymptomChecklist-90). Correlations showed that shame-proneness and event-related shame were highly inter-correlated andthat, in addition, each uniquely contributed to higher symptom levels. The guilt measures were unrelated to eachother as well as to symptoms. Structural equation modeling analyses revealed significant indirect effects supporting the role of event-related shame as mediator between shame proneness and post-victimization symptoms. In conclusion, requiring attention in clinical settings, both shame proneness and event-related shame seem to bepotent risk factors for distress after victimization.

A review of the literature on the subject along with results from cross-sectional research will be presented to illustrate the relationships between self-conscious emotions and mental health in crime victims.

Crime victims receive relevant treatment too seldom and there is uncertainty as to whether those who need the treatment the most are among those who get it. Fifty-two consecutive adult crime victims were offered 10 sessions of psychotherapy within two weeks after an experienced trauma of criminal victimization. Twenty-six accepted and 26 declined the offer. The aim of the study was to explore some of the differences between these two groups. The results show that the therapy group presented a higher incidence of acute stress disorder, more negative scorings regarding immediate reactions (to the crime), more subjective ratings of physical and psychological health (GAF, according to DSM IV), and more psychiatric and trauma-related symptoms as compared to the non-therapy group. A conclusion was that those who needed treatment the most also accepted it. Traumatized people may, due to avoidant strategies, withdraw from potential treatment. Conversely, the therapy group scored higher on the coping style escape-avoidance.

The Test of Self-Conscious Affect (TOSCA) is a well-established scenario-based questionnaire assessing self-conscious emotions, such as shame and guilt, which have been shown to be differentially associated with a variety of functional, motivational, behavioral and health outcomes. The aim of this study was to evaluate the psychometric properties and internal structure of a Swedish version of TOSCA in a sample of 361 healthy adults. The psychometric properties and internal consistency of the Swedish version were at level with the original US TOSCA version for shame, guilt and detachment. The internal structure of the Swedish version was acceptable for shame, guilt and detachment but contained shortcomings in assessment of externalization.

The aim of this study was to explore the prevalence of current suffering and the role of peritraumatic emotions and other risk factors for development of post-traumatic and general symptoms eight months post crime. Questionnaires assessing trauma-specific symptoms (HTQ) and general psychiatric symptoms (SCL-90) was used along with a semistructured interview covering subjective reactions of 41 civilian victims of interpersonal crime. Victims proved to still be suffering, in varying degrees, from post-traumatic symptoms and other psychological distress. Females reported more trauma-specific symptoms and other comorbid conditions than males. Prior trauma, adverse childhood, being female, previous psychiatric history, and unemployment were all associated with more distress. Peritraumatic reactions (especially secondary emotions following cognitive appraisals after the event) predicted the three core PTSD symptoms and comorbid conditions. Apart from the PTSD symptoms, an assessment of background factors, general psychiatric symptoms, peritraumatic emotions and their cognitive associated scripts in the initial post-trauma period could be helpful in identifying victims who are at risk of developing trauma symptoms.

This paper contributes to the understanding of the factors that are significant for returning to work, and identifies factors that might be used early on in a period of sick leave to discern whether people are likely to work again. In the design, the multivariate Partial Least Squares (PLS) of Latent Structures method was used to analyse information from a questionnaire containing socio-demographic items, and information on symptoms, consequences on daily life, expectations and psychosocial factors. Data about the incidence of sickness over a four-year period was included. 121 adults aged 18-64 years on sick leave participated, irrespective of their diagnoses. A reliable prediction of a return to work required the combination of many factors: individual psychosocial instruments are not useful when considered in isolation. The strongest predictive factors for a return to work concern the individuals' expectations, the number of days of sick leave taken in the past, somatic disorders, and a high level of life satisfaction and sense of coherence. Many factors influence the outcome for people on sick leave: PLS analysis demonstrated that a multivariate approach using this method could predict the long-term outcome early on in a period of sick leave.