Neuroscientific account of Guilt- and Shame-Driven PTSD phenotypes

Translated title of the contribution: Neuroscientific account of Guilt- and Shame-Driven PTSD phenotypes

Naomi B. Fine, Ziv Ben-Zion, Iftah Biran, Talma Hendler*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Guilt and Shame, two core self-related emotions, often emerge following trauma and play an important role in the development and maintenance of post-traumatic stress disorder (PTSD). Importantly, Guilt and Shame exhibit specific focal and non-specific global impacts of trauma on self-perception, respectively. Objective and Methods: Integrating psychological theories with neuroscientific knowledge, we suggest a scheme of two diverging clinical phenotypes of PTSD, associated with distinct self-related processes and differential functionality of relevant neural networks. Proposal: The Guilt-driven phenotype is characterized by preoccupation with negative self-attributes of one's actions in the traumatic event. It involves altered functionality of both the salience network (SN) and the default-mode network (DMN), associated with heightened interoceptive signalling and ruminative introspection which may lead to hyperarousal and intrusive symptoms, respectively. On the contrary, the Shame-driven phenotype is characterized by global, identity-related negative self-attributions. It involves altered functionality of both the SN and the DMN, associated with blunted interoceptive signalling and diminished introspection which may result in withdrawal and anhedonia symptoms together with dissociative experiences, respectively. Conclusion: The proposed PTSD phenotypes may inform neuropsychological therapeutic interventions (e.g. self-focused psychotherapy and neuromodulation) aiming to restore the function of large-scale self-related neural processing.

Translated title of the contributionNeuroscientific account of Guilt- and Shame-Driven PTSD phenotypes
Original languageEnglish
Article number2202060
JournalEuropean Journal of Psychotraumatology
Issue number2
StatePublished - 2023


FundersFunder number
European Union's Horizon 2020 Framework Programme for Research and Innovation945539
Horizon 2020777084


    • Guilt
    • Post-Traumatic Stress Disorder (PTSD)
    • Shame
    • Trauma
    • self


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