The burden of shame: PTSD symptoms and social support in Arabic-speaking women survivors of sexual violence

Abstract

ABSTRACT Background: Research has consistently linked symptoms of posttraumatic stress disorder (PTSD) to diminished social support. Key factors that may explain this relationship are trauma-related shame, guilt, and self-blame, which are common among survivors of sexual violence. Objective: This study investigates the mediating role of trauma-related shame, guilt cognitions, and self-blame in the association between PTSD symptoms and perceived social support among Arabic-speaking women with a history of sexual violence exposure. Methods: Participants included N  = 3,419 Arabic-speaking, treatment-seeking women with a history of sexual violence exposure who registered for an online intervention. First, correlational analyses examined the association between PTSD symptoms, trauma-related shame, guilt cognitions, and self-blame. Second, a parallel mediation tested whether these three constructs mediated the association between PTSD symptoms and perceived social support. All variables were assessed using standardized self-report questionnaires. Results: Trauma-related shame, guilt cognitions, and self-blame were positively correlated with PTSD symptoms (r = .54, r = .28, and r = .45, respectively). Higher PTSD symptoms were associated with lower perceived social support (β = −0.21). In the mediation model, trauma-related shame emerged as the most explanatory mediator, partially accounting for the association between higher PTSD symptoms and lower perceived social support. By contrast, guilt cognitions showed a small indirect effect in the opposite direction, whereas self-blame showed no significant indirect effect. Conclusion: These findings suggest that trauma-related shame may play a role in the relationship between PTSD symptoms and perceived social support among women with a history of sexual violence exposure, and should therefore be considered in diagnostic processes and psychotherapeutic interventions.