The present study explores the relationship between guilt, sense of control, and posttraumatic stress disorder. Seventy-eight participants who had experienced a traumatic event completed the following self-report measures online: the Posttraumatic Stress Diagnostic Scale, the Guilt Cognitions subscale of the Trauma-Related Guilt Inventory, the Posttraumatic Cognitions Inventory, and Sense of Control During the Trauma. Results revealed that “behavioral self-blame” that refers to functioning during the trauma, positively correlated with posttraumatic stress symptoms. However, when Sense of Control During the Trauma was introduced into the analysis, this correlation appeared only for participants who had experienced lack of control during the traumatic event. Among the participants who had experienced a sense of control, no such link was found. Results suggest that guilt may be produced to avoid feelings of helplessness following the trauma, because guilt conveys a sense of control.

Background: Feeling out of control during a traumatic event may evoke behavioral self-blame (BSB) to avoid feeling helpless following trauma by restoring one’s sense of control. BSB is a common, persistent, and treatment-resistant post-traumatic stress symptom. The present study investigates the etiology and risk factors of BSB following a traumatic event and the reasons for its persistence over time. Method: Subjects were a group of 546 Israeli ex-combat soldiers (M age = 24.93 ± 5.657) registered in an Israel Defense Forces (IDF) combat reaction clinic. All completed the Peritraumatic Dissociative Experiences Questionnaire (PDEQ), the Brief Symptom Inventory (BSI), and the PTSD Checklist for the DSM-5 (PCL-5). Item 10 of the PCL-5 served to measure BSB. The PDEQ and BSI measured distress and feeling out of control during the event. We used descriptive analyses of the data, t-test, and linear regression analysis to reveal the relationship between the research variables. Results: Feeling out of control during a traumatic event often increases BSB and post-traumatic stress symptoms. A significant correlation emerged between continuing distress characterizing individuals who experience a persistent lack of control and BSB. Female combat soldiers were at a higher risk of BSB than their male counterparts. Conclusion: Loss of control experienced during a traumatic event may result in persistent long-term feelings of lack of control over one’s behavior.

Exposure to severe combat situations significantly raises the risk of depression and post-traumatic stress disorder (PTSD). Trauma survivors may use dissociation as a defense mechanism, increasing the likelihood of PTSD. This study aims to explore the roles of dissociation and depression in PTSD among soldiers exposed to combat who sought help from the Israel Combat Stress Reaction Unit. Method: This cross-sectional study involved 927 individuals who participated in a particular military operation in 2014 [98.5% male (n = 906); mean age = 27.08 (SD = 5.93)]. Participants completed three questionnaires: the Dissociative Experiences Scale (DES), the Beck Depression Inventory (BDI), and the Post-Traumatic Stress Symptom Checklist (PCL-5) for PTSD. Results: Our results showed that severe PTSD (PCL score ≥ 33) was found in 30.4% of participants, and 76.6% showed dissociative symptoms (DES score ≥ 30). Additionally, 23.5% experienced moderate depression, while 19.1% reported severe depressive symptoms. A Generalized Linear Model revealed that both depression and dissociation significantly contribute to PTSD. Individuals with depression were three times more likely to experience post-traumatic symptoms compared to 1.23 times for those with dissociative symptoms. Conclusions: Life-threatening situations significantly predicted higher PTSD symptoms, serving as a risk factor for depression and dissociation, which play important roles in PTSD, with depression having notably greater impact.