The Centrality of Humiliation in Complex Posttraumatic Stress Disorder

ABSTRACT

Victims of traumatic events that involve repeated interpersonal aggression and low or no chance of escape frequently report intense Self-Conscious Emotions (SCEs), such as Shame, Guilt, and Humiliation. Humiliation is the reaction to a forced loss of status and is hypothesized to have unique contributions to the development and maintenance of Posttraumatic Stress Disorder (PTSD) and Complex Posttraumatic Stress Disorder (CPTSD). However, previous studies did not include humiliation or did not simultaneously probe the relative contribution of each SCE to posttraumatic symptoms. This study aimed to investigate the dynamics between specific SCEs and trauma-related symptomatology in the general population who suffered a form of complex trauma. Four hundred forty-nine people (77.11% women) exposed to domestic violence and sexual abuse answered an online survey. We investigated whether each emotion would accurately predict probable PTSD and CPTSD levels above the proposed cutoff. We estimated a network model to understand the dynamics of their interactions and whether the traumatic event type would moderate relationships between SCEs and posttraumatic stress symptoms, comparing networks of two types of complex trauma. No SCE predicted PTSD, but humiliation was a predictor of CPTSD while controlling for Shame and Guilt. Humiliation was also the most central SCE domain in the networks of both traumatic events. Our results stress the relevance of Humiliation to understanding posttraumatic stress symptoms and the necessity to consider humiliation when studying the emotional processing in complex trauma.

KEYWORDS:

• Trauma
• humiliation
• self-conscious emotions
• posttraumatic stress disorder
• complex posttraumatic stress disorder

Acknowledgments

This work was supported by grant funding from CAPES (master’s scholarship; PROEX financing) and CNPq (research productivity grant).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, I.A., upon reasonable request.

CRediT

Conceptualization, Methodology, and Supervision: IA and GG. Formal analysis, investigation, software, project administration, validation, visualization, and writing-original draft: IA. Funding acquisition, Resources, and Writing – review and editing: GG. All authors read and approved the final manuscript.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/15299732.2024.2383182

Additional information

Funding

The work was supported by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) [research productivity grant] Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) [master’s scholarship; PROEX financing].