Veterans’ trauma-related guilt and self stigma affect treatment-seeking behavior

Abstract: The vast majority of veterans experience traumatic events; however, few go on to develop clinically significant posttraumatic stress disorder (PTSD). Of those that do develop PTSD, the number of traumatic events is associated with worsening PTSD. Among veterans with PTSD, treatment seeking is generally low and among those in treatment, dropout rates are high; thus, exploring mechanisms that may facilitate treatment seeking is pivotal. Along these lines, trauma-related guilt (TRG) and mental health self-stigma (MHSS) are reported at elevated rates among combat veterans and have been associated with increased PTSD severity and decreased treatment-seeking behaviors (e.g., attending therapy). The current study explores the associations between the variables TRG, MHSS, trauma exposure, and the number of traumatic events a veteran experiences with help-seeking behaviors among combat veterans. Participants (N = 211) completed an online survey assessing demographics, PTSD, treatment-seeking behaviors, TRG, and MHSS. Results suggest TRG and MHSS mediate the association between the number of traumatic events a veteran experienced and their help-seeking behavior. The overall model was significant (F = 15.8, p < 0.001, R2 = 0.37). TRG and MHSS mediated the relationship between number of traumatic events and help-seeking behavior (b = –.45, p < 0.05). The directionality was significant if TRG first predicted MHSS and not the other way around. Results suggest TRG may impact MHSS development and maintenance in veterans with traumatic experiences. These findings suggest targeting TRG and MHSS in interventions for veterans, especially those with trauma exposure, to increase their help-seeking behaviors.