Forgiveness Impacts Post-Traumatic Stress Disorder Severity

Newswise — Vietnam War veterans were the first to be diagnosed with post-traumatic stress disorder (PTSD), a condition that health experts fear will afflict many of the veterans returning from current combat in Iraq and Afghanistan. A recent study of 213 help-seeking Vietnam vets diagnosed with PTSD found that difficulty forgiving others, difficulty forgiving oneself and negative religious coping " interpersonal religious discontent, questioning God's powers, and/or appraisal of the problem as God's punishment " were associated with depression, anxiety, and PTSD symptom severity.

Lead researcher Dr. Charlotte vanOyen Witvliet, associate professor of psychology at Hope College in Holland, Mich.; joined with Kelly Phipps and Michelle Feldman, both then with the Durham (N.C.) Veteran Affairs Medical Center; and Dr. Jean Beckham, also a psychologist with the Durham (N.C.) VA Medical Center and jointly associate professor of medical psychiatry at Duke University Medical Center. They authored a paper titled "Posttraumatic Mental and Physical Health Correlates of Forgiveness and Religious Coping in Military Veterans," which was published last June in the Journal of Traumatic Stress " the professional journal of the International Society for Traumatic Stress Studies. The John Templeton Foundation awarded a grant for Scientific Studies on the Subject of Forgiveness to Witvliet.

"What we found is that the veterans who had difficulty forgiving others, difficulty forgiving themselves, and who used more negative religious coping approaches had greater levels of depression and more intense post-traumatic stress symptoms. Difficulty forgiving themselves was also related to more anxiety in general. All of these relationships held even after controlling for age, socioeconomic status, ethnicity, combat exposure, and hostility," said Witvliet, who had collaborated with Hope colleagues on a 2001 study finding that unforgiving thoughts prompted more aversive emotion, and significantly higher physiological responses " like increased blood pressure and heart rate " while the forgiving thoughts prompted greater perceived control and comparatively lower physiological stress responses.

The researchers drew data for this study from a Veteran Affairs Medical Center outpatient PTSD clinic located in the southeast from July 1998 to January 2000. During this period, 336 male and female veterans presented to the clinic for a standardized clinical evaluation. Participants were asked to complete three assessment sessions " a questionnaire packet, formal personality testing, and administration of the Clinician-Administered PTSD Scale. Combat exposure was evaluated using the Combat Exposure Scale. Subjects were excluded because of absence of PTSD diagnosis (100), female gender (7), or missing data for any study variables (16) " leaving the remaining 213 as sample subjects.

The study found significant associations between dispositional difficulty forgiving others, difficulty forgiving oneself, and negative religious coping with difficulties in mental health for military veterans with PTSD. Positive religious coping " seeking spiritual support, collaboration with God in solving the problem, positive religious appraisals of the problem " also did not have the expected inverse relationship with mental health difficulties.

"Associations between guilt and mental health support the importance of further investigating the clinical utility of forgiveness and religious coping in assessments and interventions that are sensitive to their complexities in the context of trauma," said Witvliet.

"An emerging literature indicates that interventions which sensitively assist clients in forgiving others may offer mental health benefits, even in those who judge their interpersonal offenses to be severe. The current data suggest that in addition to forgiveness of others, forgiveness of oneself and religious coping may be important in the clinical evaluation and treatment of individuals with PTSD."

Dick Jones Communications assists Hope with its public affairs work.