Validation of the embarrassment, guilt, and shame scale among Veterans seeking treatment for posttraumatic stress disorder

Abstract: OBJECTIVE: Embarrassment, guilt, and shame are negative self-evaluations (NSEs) implicated in a number of psychiatric conditions, including posttraumatic stress disorder (PTSD). Despite their conceptual differences, evidence suggests that each NSE shares considerable variance, complicating efforts to understand their unique contribution to psychopathology and treatment progress. To address this limitation, we developed the Embarrassment, Guilt, and Shame Scale (EGSS), a brief tool designed to assess all three NSEs simultaneously for use in clinical and research settings. METHOD: One hundred one veterans referred for PTSD treatment completed the EGSS as part of a standard intake process, which included both clinician- and self-reported measures of PTSD symptom severity. Both exploratory and confirmatory factor analyses were used to identify and then validate the best fitting model. RESULTS: Controlling for age and sex, results supported a three-factor model, confirming the distinctiveness of embarrassment, guilt, and shame. Each NSE yielded significant correlations with PTSD symptoms at intake. Significant but moderate correlations with other validated measures provided evidence for convergent validity. CONCLUSIONS: The EGSS shows promise as a psychometrically sound measure that assesses three distinct NSEs linked to PTSD symptoms. It also offers promise for improving treatment planning by identifying emotional barriers to recovery. However, findings are based on a single veteran sample. Replications with more diverse populations are necessary to strengthen the generalizability and reliability of the EGSS across psychiatric conditions.

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