title: Combat-related guilt mediates the relations between exposure to combat-related abusive violence and psychiatric diagnoses.
abstract: BACKGROUND
  This study examined the degree to which combat-related guilt mediated the relations between exposure to combat-related abusive violence and both Posttraumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD) in Vietnam Veterans.
  
  
  METHODS
  Secondary analyses were conducted on data collected from 1,323 male Vietnam Veterans as part of a larger, multisite study.
  
  
  RESULTS
  Results revealed that combat-related guilt partially mediated the association between exposure to combat-related abusive violence and PTSD, but completely mediated the association with MDD, with overall combat exposure held constant in the model. Follow-up analyses showed that, when comparing those participants who actually participated in combat-related abusive violence with those who only observed it, combat-related guilt completely mediated the association between participation in abusive violence and both PTSD and MDD. Moreover, when comparing those participants who observed combat-related abusive violence with those who had no exposure at all to it, combat-related guilt completely mediated the association between observation of combat-related abusive violence and MDD, but only partially mediated the association with PTSD.
  
  
  CONCLUSIONS
  These findings suggest that guilt may be a mechanism through which abusive violence is related to PTSD and MDD among combat-deployed Veterans. These findings also suggest the importance of assessing abusive-violence related guilt among combat-deployed Veterans and implementing relevant interventions for such guilt whenever indicated.
authors.affiliation: Behavioral Sciences Division of the VA National Center for PTSD, VA Boston Healthcare System, 150 S. Huntington Avenue, Boston, MA 02130, USA. brian.marx@va.gov
authors.forename: Brian P
authors.initials: BP
authors.lastname: Marx
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Foley
authors.forename: Brian A
authors.initials: BA
authors.lastname: Feinstein
authors.forename: Erika J
authors.initials: EJ
authors.lastname: Wolf
authors.forename: Danny G
authors.initials: DG
authors.lastname: Kaloupek
authors.forename: Terence M
authors.initials: TM
authors.lastname: Keane
mesh_terms: D000328:Adult; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D006167:Guilt; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D011795:Surveys and Questionnaires; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data*; D047829:Vietnam Conflict; D014754:Violence / Q000523:psychology* / Q000706:statistics & numerical data*