The Influence of Trauma-Related Shame on the Associations Between Posttraumatic Symptoms and Impulsivity Facets

Clinical Impact Statement Posttraumatic symptoms (PTS) and impulsivity facets of lack of premeditation and lack of perseverance were significantly positively related at low (but not high) levels of trauma-related shame (TRS). Findings highlight the need for clinicians to recognize, understand, and explain the nuanced role of TRS on the relation between PTS and impulsivity to improve case conceptualization and treatment. TRS may drive distorted thoughts around safety, which in turn may reduce impulsivity but also prevent healthy forms of risk, such as those needed to allow for trauma processing (e.g., exposure to corrective information). Introduction: The co-occurrence of posttraumatic symptoms (PTS) and impulsivity is associated with higher levels of risky and self-destructive behaviors and consequent safety and health risks. Trauma-related shame (TRS) may influence the association between PTS and impulsivity such that engaging in impulsive behaviors may serve to cope with emotional distress. Alternatively, TRS may motivate a deliberate consideration of behaviors (i.e., less impulsivity) to prevent further cognitive and emotional distress. Objective: The goal of the current study was to examine the influence of TRS on the associations between PTS and impulsivity facets (lack of premeditation, lack of perseverance, negative urgency, positive urgency, sensation seeking). Method: Data were collected from 506 community individuals who endorsed lifetime sexual trauma (M-age = 34.56, 54.3% women, 78.7% White). Results: Findings indicated that TRS moderated associations between PTS and impulsivity facets of lack of perseverance, b = -.001, SE = .0003; t = -2.68, p = .008, 95% confidence interval [-.001, -.0002], and premeditation, b = -.001, SE = .0003; t = -3.70, p < .001, [-.002, -.001]; these associations were significant at low, but not high, levels of TRS. Conclusions: Findings suggest that in the context of PTS, TRS may reduce certain forms of impulsivity, potentially as a means to self-protect against further cognitive and emotional distress. Findings have important implications for understanding how individuals regulate and respond to shame in the context of PTS.