Differences in Trauma-Related Guilt in Females with History of Sexual Violence Based on Insomnia Severity

Abstract

BACKGROUND AND OBJECTIVE: Females with history of sexual violence report a high percentage of insomnia. Guilt is a common symptom among this group. This study investigated differences in trauma-related guilt cognition between females of sexual violence with high or low symptoms of insomnia. METHODS: Participants were 43 females who reported having a history of sexual violence (mean age 26.56±7.81). All participants completed questionnaires about insomnia symptoms (Insomnia Severity Index, ISI), Posttraumatic stress disorder (PTSD) symptoms (PTSD Symptom Scale Self-Report), trauma-related guilt (Trauma-related Guilt Inventory, TRGI), depression (Beck Depression Inventory) and trauma-related information. The TRGI is consisted by global guilt, distress and guilt cognitions. Guilt cognitions can further be divided into Hindsight-Bias/Responsibility, Wrongdoing, and Lack of Justification subscales. Analyses were conducted using Pearson’s correlation coefficient and analysis of covariance. RESULTS: Results indicated ISI scores were significantly positively associated with PSS scores (r = 0.620, p < 0.01) and the distress subscale of the TGRI (r = 0.488, p < 0.01), and negatively associated with guilt cognitions (r = -0.423, p < 0.01). 53.5% (n = 23) of the sample met criteria for clinical insomnia using ISI cut-off scores of 15. Participants in the insomnia group scored significantly lower in overall guilt cognitions (p < 0.001) and significantly higher in distress (p = 0.001) than the non-insomnia group after controlling for depression. Among the subscales of guilt cognitions, hindsight-bias/responsibility was significantly lower in the insomnia group (p < 0.001). CONCLUSIONS: Guilt can sometimes be adaptive in trauma patients as it may work as a catalyst in cognitively processing their trauma. Our results indicate that individuals with insomnia report lower guilt cognition. This may subsequently interfere with their ability to process the traumatic experience and effectively cope with their situation.